Sick: A Memoir by Porochista Khakpour


“Everyone who is born holds dual citizenship in the kingdom of the well and in the kingdom of the sick,” begins Susan Sontag’s 1977 essay Illness as Metaphor. Sontag, who challenged the shaming language used for sufferers with severe diseases such as cancer and tuberculosis, continues with warning : “Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.” Porochista Khakpour, channels this idea throughout her memoir, Sick, exploring what it means to be “sick”, while she tries to reconcile her dual nationality of Iran and America, and her eternal antagonism of psychological and physical pain. 

Hospitals, anonymity, and disease had become Khakpour’s homeland. 

Khakpour was first diagnosed with late-stage Lyme disease in 2011. The diagnosis itself caused “very little alarm” to the Tehran-born writer. Jacob, her boyfriend at the time, was convinced that she had caught Lyme as a child in California, and that she had to be “grateful” and “just get on with [your] life” and “write those books you write!” Khakpour did, in fact, write two acclaimed novels: Sons and Other Inflammable Objects (2007) and The Last Illusion (2014). Lyme, a multi systemic illness that affects the nervous system is known to cause a range of psychiatric symptoms such as major depression, obsessive-compulsive disorder, anorexia nervosa and paranoia. Therefore, a childhood infection of Lyme, rather than the war-torn trauma of her Iranian upbringing, and body dysmorphia, could explain the psychological instability of Khakpour’s adolescence and college years. However, the omission of Lyme’s psychiatric impact in her introductory Author’s Note, suggests that she may want the reader to believe that a romantic kind of madness is intrinsic to her nature. 

The book’s chapters are interspersed with personal reflections and Odyssean rites of passage: Khakpour’s lonely, disenchanted childhood in Los Angeles which ignited her literary compulsion; then her addiction-ridden twenties in New York and Baltimore; wandering throughout the USA and the world in the pursuit of a writing and academic career, healing and encountering many friends and lovers along the way; returning to her spiritual home of New York. Her lifelong lack of consistency in relationships and identity is revealed after she is hospitalized after relapse in 2016: “The beeps and the buzzing, the rapid sound of heels, the screams and the cries, the occasional expressions of joy—this was a home of sorts, I had to and hated to admit.” Hospitals, anonymity, and disease had become Khakpour’s homeland. 

Sickness as structure permeates throughout the narrative too. Lyme being a neuropsychiatric illness, affects the body, blood, and brain similarly to how the chaotic and diffused narration of Sick makes the reader uncomfortable and troubled. “How could my body erupt in a chaos of spirochetes each time my mind and body suffers? How does that work? And yet we continue to find evidence of the mind and body connection”, she says of her fluctuations with illness, reactions to world politics, and a quest for exile. 

Observations on her forced and conscious solitudes creates pathos: “I carried out none of my plans to see friends and instead stayed in a lot.” she writes about going back to her “beloved” New York after a suicide attempt in Leipzig, Germany. She was prone to spend Christmas, New Year’s Eve and Thanksgiving alone when she was in an “off-period”, yet her ultimate fear was to be “the woman artist alone in New York, who lives a wild and unconventional life only to succumb to the most standard and conventional institution of all: death.” 

She does not, however, succumb to turning her story into a hackneyed tortured artist portrayal. She put her “fancy writer ego” aside to entangle the toil of writer and diseased life, so that it became less romantic and more heroic. When she reflects on the disappearance of her aunt Simin, a New York artist whom she admired, she realizes that her aunt’s worst fate was not completing her life’s work. For Khakpour, Sick is her life’s work, which she completed while on a roller coaster of dependency, crippling emotional and bodily pain and uncertainty: The Book I Sold was a story of triumph’ to use her words, it is also a testament of perseverance for the marginalized and the sick. 

After traveling the world in 2014, insomnia again catches up with her in Indonesia for which she attributes to the Paris attacks and academic pressures, she writes: “The world felt unconquerably unstable. But something also felt wrong within me, and I could not figure it out.” Khakpour’s extraordinary personal odyssey is as mercurial as the world she lives in: “There was never a home for me as a human in the world—which is why moving around was almost easy.”


Sick: A Memoir is available now. 


Words: Nikki Hall

Photos: Sylvie Rosokoff