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The Invisible Kingdom
The Invisible Kingdom の表紙
The Invisible Kingdom
Reimagining Chronic Illness
著者 Meghan O'Rourke
A NEW YORK TIMES BESTSELLER
FINALIST FOR THE 2022 NATIONAL BOOK AWARD FOR NONFICTION
Named one of the BEST BOOKS OF 2022 by NPR, The New Yorker, Time, and Vogue

Remarkable.” –Andrew Solomon, The New York Times Book Review

"At once a rigorous work of scholarship and a radical act of empathy.”Esquire
"A ray of light into those isolated cocoons of darkness that, at one time or another, may afflict us all.” —The Wall Street Journal

"Essential."—The Boston Globe

A landmark exploration of one of the most consequential and mysterious issues of our time: the rise of chronic illness and autoimmune diseases

A silent epidemic of chronic illnesses afflicts tens of millions of Americans: these are diseases that are poorly understood, frequently marginalized, and can go undiagnosed and unrecognized altogether. Renowned writer Meghan O’Rourke delivers a revelatory investigation into this elusive category of “invisible” illness that encompasses autoimmune diseases, post-treatment Lyme disease syndrome, and now long COVID, synthesizing the personal and the universal to help all of us through this new frontier.
 
Drawing on her own medical experiences as well as a decade of interviews with doctors, patients, researchers, and public health experts, O’Rourke traces the history of Western definitions of illness, and reveals how inherited ideas of cause, diagnosis, and treatment have led us to ignore a host of hard-to-understand medical conditions, ones that resist easy description or simple cures. And as America faces this health crisis of extraordinary proportions, the populations most likely to be neglected by our institutions include women, the working class, and people of color.
 
Blending lyricism and erudition, candor and empathy, O’Rourke brings together her deep and disparate talents and roles as critic, journalist, poet, teacher, and patient, synthesizing the personal and universal into one monumental project arguing for a seismic shift in our approach to disease. The Invisible Kingdom offers hope for the sick, solace and insight for their loved ones, and a radical new understanding of our bodies and our health.
A NEW YORK TIMES BESTSELLER
FINALIST FOR THE 2022 NATIONAL BOOK AWARD FOR NONFICTION
Named one of the BEST BOOKS OF 2022 by NPR, The New Yorker, Time, and Vogue

Remarkable.” –Andrew Solomon, The New York Times Book Review

"At once a rigorous work of scholarship and a radical act of empathy.”Esquire
"A ray of light into those isolated cocoons of darkness that, at one time or another, may afflict us all.” —The Wall Street Journal

"Essential."—The Boston Globe

A landmark exploration of one of the most consequential and mysterious issues of our time: the rise of chronic illness and autoimmune diseases

A silent epidemic of chronic illnesses afflicts tens of millions of Americans: these are diseases that are poorly understood, frequently marginalized, and can go undiagnosed and unrecognized altogether. Renowned writer Meghan O’Rourke delivers a revelatory investigation into this elusive category of “invisible” illness that encompasses autoimmune diseases, post-treatment Lyme disease syndrome, and now long COVID, synthesizing the personal and the universal to help all of us through this new frontier.
 
Drawing on her own medical experiences as well as a decade of interviews with doctors, patients, researchers, and public health experts, O’Rourke traces the history of Western definitions of illness, and reveals how inherited ideas of cause, diagnosis, and treatment have led us to ignore a host of hard-to-understand medical conditions, ones that resist easy description or simple cures. And as America faces this health crisis of extraordinary proportions, the populations most likely to be neglected by our institutions include women, the working class, and people of color.
 
Blending lyricism and erudition, candor and empathy, O’Rourke brings together her deep and disparate talents and roles as critic, journalist, poet, teacher, and patient, synthesizing the personal and universal into one monumental project arguing for a seismic shift in our approach to disease. The Invisible Kingdom offers hope for the sick, solace and insight for their loved ones, and a radical new understanding of our bodies and our health.
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引用-
  • From the cover

    one

     

    "Gradually and Then Suddenly"

     

    In the fall of 1997, after I graduated from college, I began experiencing what I called "electric shocks"-stabbing sensations that flickered over my legs and arms every morning, as if I were being stung by tiny bees. The shocks were so extreme that as I walked to work from my East Village basement apartment, I often had to stop and rub my legs against a parking meter; if I didn't, my muscles would twitch and my legs would jerk. My doctor couldn't figure out what was wrong-dry skin, he proposed-and eventually the shocks went away. A year later, they returned for a few months, only to go away again just when I felt I couldn't bear them any longer.

     

    In my twenties, the shocks and other strange symptoms-bouts of vertigo, fatigue, joint pain, memory problems, night sweats, tremors-came and went. For a year, every night around two a.m., I would wake up in a sweat to find hives covering my legs, leaving me itchy and wide awake, my pajamas and sheets so wet I had to change them. Doctors prescribed a daily dose of antihistamines until the hives went away. There was a test that suggested lupus, and then a follow-up that showed nothing was wrong; my lab work looked fine. "The tests were all negative. It's just one of those things that will go away," a specialist told me. I remember thinking, Don't you want to know why I have severe hives?

     

    In the way of women who have internalized disordered ideas about food and control, I associated my strange bouts of fatigue and discomfort with eating poorly (even though I ate a reasonably healthy diet). It was easy, in those years, to feel that a lack of dietary discipline played a role in my exhaustion, because I could tell, vaguely, that certain foods made me feel worse, leading me to assume responsibility for my own unwellness. I toggled between the conviction that something had to be wrong-I didn't feel OK-and the conviction that I was to blame, and if I just stopped eating sugar, or pizza, say, I'd be fine.

     

    One night, I woke up suddenly from a nightmare that a man in a dirty gray sweatshirt was stabbing me. My period had started, but in addition to the cramps I had a sharp pain in my lower right abdomen. The pain grew in magnitude until, heat flushing my body, I suddenly vomited. I thought perhaps I had appendicitis, but the pain went away an hour later, just as I was preparing to go to the ER. "Everyone feels cramps," my gynecologist told me when I asked about it.

     

    At the advice of a friend, I went to see her gynecologist. This doctor listened and nodded when I mentioned the stabbing pain; I felt relief at the recognition. She did an exam and ultrasound. "I think you might have endometriosis, an immune-modulated disease where tissue from the uterus gets out and coats the abdomen and other organs, causing pain," she said. "But it doesn't really matter unless you want to get pregnant: it can cause infertility. Later we might want to address it with surgery. For now, I'd just take ibuprofen during your period." She gave me some tissues and I wiped myself, dressed, and left, puzzled by the way my pain had been relegated to a sign that my fertility might be compromised, not a problem in its own right.

     

    When I was twenty-four, I started waking up with a feeling that a foggy miasma filled my brain. I would go for long runs before work to clear my head, lacing up my shoes, sweating off the sleep hangover. I thought everyone felt this way, that I was just fighting off a cold. But why was I so often on the verge of a cold-more than anyone else I knew? Periodically, I would start...

レビュー-
  • Library Journal

    October 1, 2021

    Admired poet O'Rourke, who came to the forefront with The Long Goodbye, a memoir about mourning, returns with a work that draws on her own experiences as well as 15 years of interviews with doctors, patients, researchers, and public health experts to examine why chronic and particularly autoimmune disease is escalating in the United States. As COVID-19 emerged, she refocused her efforts to include it in her study, which makes it especially relevant to what's called "the Long Covid"--that is, the persistence of symptoms from fever to fatigue that have affected some survivors.

    Copyright 2021 Library Journal, LLC Used with permission.

  • Kirkus

    December 15, 2021
    Tormented for years by enervating symptoms, the author spent most of her 30s dealing with--and trying to understand--chronic illness. "To become chronically ill is not only to have a disease that you have to manage," writes poet and Yale Review editor O'Rourke, "but to have a new story about yourself, a story that many people refuse to hear--because it is deeply unsatisfying, full of fits and starts, anger, resentment, chasms of unruly need. My own illness story has no destination." Here, the author constructs that story from building blocks of personal narrative and science journalism, with deep dives into the technicalities of the immune system and the microbiome. The personal sections are engaging and well written--"What I had wasn't just an illness now; it was an identity, a membership in a peculiarly demanding sect. I had joined the First Assembly of the Diffusely Unwell. The Church of Fatigue, Itching, and Random Neuralgia. Temple Beth Ill"--as O'Rourke ably documents her myriad appointments with both Western and alternative practitioners, toting thick stacks of medical records, exploring various autoimmune diagnoses and treatment plans. Some are bizarre and/or dubious, others disgusting but legit (fecal microbiota transplant). Just when the author felt totally lost in the labyrinth of Lyme disease, prescribed the very antibiotics she believed had damaged her body in the first place, she finally found the beginning of a road to health. Though O'Rourke roundly rejects the notion that illness and suffering are somehow balanced by spiritual benefits, her conclusion offers hope. "Today, as a new paradigm for disease is emerging--pushed into full view by the coronavirus pandemic and the epidemic of long COVID--we must amend the simple 'germ causes disease, body overcomes disease' model....A holistic, individualized approach to medicine may matter more than was once thought." Emotionally compelling and intellectually rich, particularly for those with a personal connection to the issue.

    COPYRIGHT(2021) Kirkus Reviews, ALL RIGHTS RESERVED.

  • Publisher's Weekly

    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.

  • Booklist

    February 1, 2022
    What does it mean to have a disease doctors can't diagnose? In her pensive inquiry into chronic illness, O'Rourke chronicles lots of tests and expense, frustration and anger, continued suffering and grief, uncertainty and lack of control, and skepticism from health care professionals and friends. Admitting to feeling ""intermittently unwell"" since college graduation and slowly worsening, she recounts an assortment of symptoms, including fatigue, aches, rash, fever, and brain fog. At one point, O'Rourke had nine doctors. While receiving conventional therapies (thyroid medication, antibiotics), she also sought alternative and complementary treatments. She perused internet forums where information, advice, and support were readily available. A definitive, unifying diagnosis remained elusive. O'Rourke was told she suffered from autoimmune thyroiditis, postural orthostatic tachycardia syndrome, genetic hypermobile Ehlers-Danlos syndrome, and chronic Lyme disease. Lessons learned: Anxiety, loneliness, and depression can accompany chronic disease. A trusting doctor-patient relationship is vital. Empathy is essential. Citing chronic fatigue syndrome, fibromyalgia, and chronic Lyme disease as examples, O'Rourke notes that many chronic conditions are poorly understood or controversial, which leads to marginalizing or delegitimizing patients' suffering. O'Rourke warns, ""The less we understand about a disease or a symptom, the more we psychologize, and often stigmatize, it."" An affecting portrayal of how we view disease, experience illness, and search for healing.

    COPYRIGHT(2022) Booklist, ALL RIGHTS RESERVED.

  • Library Journal

    Starred review from February 1, 2022

    In this personal and deeply moving exploration of life with chronic illness, O'Rourke (The Long Goodbye) focuses on her own illness and weaves in the history of Western medicine and interviews with medical practitioners and researchers, for an overview of how Westerners regard autoimmune disease and chronic illness. O'Rourke details that the conflict isn't necessarily between a sick person and their disease but between a sick person and symptom-based Western medicine and health care. Chronic illness, in particular autoimmune diseases, manifest as painful acute symptoms and also vague periods of "unwellness" but different and changing over time and seemingly unrelated, the author explains. Without persistent self-advocacy, a support network, and a wealth of resources (and as O'Rourke illustrates so poignantly, even with these things), diagnoses may take years or never happen. O'Rourke acknowledges the white privilege and relative wealth that color her experience and reminds readers that health outcomes and diagnoses depend on race, class, and gender identity and expression. VERDICT This work may serve as an affirmation that people living with chronic illness are not alone. For those close to one with chronic illness or who would like to learn more, this firsthand account is both moving and educational.--Rachel M. Minkin

    Copyright 2022 Library Journal, LLC Used with permission.

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The Invisible Kingdom
The Invisible Kingdom
Reimagining Chronic Illness
Meghan O'Rourke
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