BooksReviewThis is a moving examination of what it means to be human, says Hilary MantelWhen Siri Hustvedt's father died, she wrote his eulogy and at his funeral delivered it "in a strong voice, without tears". Two and a half years later, back in her Minnesota home town, she stood up to talk about him again to a college audience, on the campus where for 40 years he had been a professor of Norwegian studies. An experienced speaker, she was "confident and armed with index cards". But the speech was a disaster. She shook so violently, from the neck down, that she could hardly stay on her feet. It was, her mother said, "like an electrocution".
As a delayed grief reaction, it seemed alarmingly exaggerated. But it was not the first time her body had put on a show. A fit or seizure in a Paris art gallery had been succeeded by a feeling of euphoria and then a migraine headache which lasted the better part of a year, in the course of which she was hospitalised for investigation. Migraine, and its associated sensory disturbances, was a condition she had lived with since childhood. She was accustomed to her personal pathologies; she cherished them, even, as part of her identity. But when the shaking repeated itself, again in public, unpredictably and seemingly disconnected from emotion, she decided to launch a quest to find the shaking woman within herself, "a Mr Hyde to my Dr Jekyll, a kind of double".
Her book is a personal investigation, a philosophical inquiry, and a pithy, compacted consideration of how both psychiatry and neurology have evolved in the last two centuries. Where is her malaise located? Can it be pinned down anatomically, or is it free-floating, abstract? She undergoes brain scans, which show nothing; she ventures into psychoanalysis, in which she has a long-standing but wary interest. How, she asks, would her symptom have been classified by doctors in different eras? The 19th century might have called it hysteria, the 20th a "conversion disorder" – a symptom caused by the mind, manifesting in the body. Under stress, some people plunge into depression. Others "fall apart" and break with reality. Others express their fear and grief through encoded physical symptoms. But does it make sense to classify some conditions as somatic, others as psychic? How does physiology impact on personality? Where does the self begin and end? What is pain, and can it be abstracted from the body that suffers it, or the cultural context in which it is suffered? In these interwoven fields of knowledge, simple or single explanations barely cover the overt facts, let alone do justice to the phenomenological experience of the suffering individual. Fastidious yet engaged, intimate yet detached, Hustvedt's exploration of mind and body embraces material that is inter-disciplinary, complex and contentious.
Her clean intelligence is equal to the challenge. Her frame of reference is wide and she does not condescend to past explorers. She has more time for Freud – Freud as scientist, not as mystic – than many contemporary thinkers grant him. If parts of a theory are imperfect, she says, it does not mean it is wholly invalid. It is human to want to name, to separate, to classify, but in classifying things we may deny their complexity.
Many of the intellectual models used to explain how it feels to be human are, she says, "limited, inadequate or downright obtuse". Science needs to be rigorous in defining a field of study, or evidence will be worthless; at the same time, there are "disciplinary windows that narrow the view". Knowledge "does not always accumulate; it also gets lost". So historical understanding is vital. A psychologist cannot understand "post-traumatic distress syndrome" unless he also understands the old diagnosis of "shell shock", which is hysteria in a military uniform, hysteria masculinised. Times change. The vocabulary of suffering changes. The plurality of human response remains dazzling and baffling.
Hustvedt is an ambitious, cerebral novelist, and the links between this book and her fiction are overt. She was writing her fourth novel, The Sorrows of an American (2008), at the time of her father's death, and had his permission to weave extracts from his memoir into her fiction. For the book she invented a character she describes as "my imaginary brother". Eric Davidsen is a psychiatrist; to realise him on the page, she set out to learn his trade. She has also worked directly with psychiatric patients, and has seen how writing can help them break through to the core events of their life. She brings both knowledge and an artist's insight to her discussion of memory, language, personal identity.
Readers of Oliver Sacks will rate this book highly; as with Sacks, scientific knowledge and a powerful capacity for empathy are closely linked. Hustvedt grew up aware of her hypersensitivity – to colour, to sound, to the pains of other people – and thought that it was a character flaw. As a novelist, she has turned it into an asset. In part this book is an articulation of her inner process as a writer. When a writer is asked, how do you write, the temptation is to ask a question back: what order of explanation do you require? Mechanical? Mystical? To say how you write, you also have to say how you think, how you live. An honest answer is potentially as long as a book, as long as a life. The writer's deficits and defects may be as important as her more obvious strengths. Hustvedt is afraid that her migraines occupy the shadowy borderlands of epilepsy, a condition with a long artistic pedigree. "Although sometimes the morbid is also the transcendent, the transcendent cannot be reduced to the morbid."
She is not a romantic. Illness does not necessarily produce insight. Mostly it does not. It must be endured, accommodated. Our struggles towards health can accommodate what looks like disease. If the shaking woman is extended a measure of tolerance, she can become a companion in endeavour. It is Hustvedt's gift to write with exemplary clarity of what is by necessity unclear. Her symptom – the shaking – could be controlled, she found, by taking a beta blocker. In a narrow sense, a drug was the answer. But in a deeper sense, what was the question?
Hilary Mantel's Wolf Hall is published by Fourth Estate.
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