The Invisible Kingdom

Starred review from December 13, 2021
With a poet’s sensibility, journalist’s rigor, and patient’s personal investment, O’Rourke (The Long Goodbye) sheds light on the physical and mental toll of having a mysterious chronic illness. “I got sick the way Hemingway says you go broke: ‘gradually and then suddenly,’ ” she writes before delving into the decades-long game of cat and mouse she played with symptoms ranging from rashes to exhaustion starting in the late 1990s. As she reflects on the labyrinthine system she had to navigate before eventually being diagnosed with late-stage Lyme disease, O’Rourke traces the history of Western medicine—from the “dramatic clarity” of germ theory to its murky treatment and dismissal of patients it can’t diagnose. As she writes, “It is a truth universally acknowledged among the chronically ill that a young woman in possession of vague symptoms... will be in search of a doctor who believes she is actually sick.” Wary of “late-capitalist” illness narratives that demand either wellness or wisdom from sick people, O’Rourke shirks a tidy recovery story and instead mines her abjection, astonishment, and vulnerability—and the radical illness writings of Alphonse Daudet, Alice James, and Audre Lorde—to offer a stunningly raw account of living with the existential complexities of a sickness that “never fully resolves.” Readers will be left in awe.