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Prologue

ON THE EVENING OF JULY 4TH OF 2011, I STARTED VOMITING and found it impossible to stop. I was just back from two weeks of teaching a fiction writing workshop in Portugal, where I’d felt a little worse each day. At first, I thought I was just tired because of the time difference between Rhode Island and Europe, then that I had a cold, then that maybe it was flu. I slept more and more, felt increasingly disoriented. I was having trouble breathing, but I told myself this was just an indication that I was out of shape, that the more I walked the better I’d feel. On the back of my story collection Windeye there’s a picture of me standing in the palace of Sintra where if you look closely you’ll see my eyes are glassy, my face filmed with sweat. I’m smiling, but desperately so. I was trying to act like I was fine. I was, after all, the teacher. I was there to be the one who helped others, not the one who needed help.

By the time I was convinced I needed a doctor, the workshop was almost over. Since I found daunting the idea of going to a doctor in a country where I didn’t speak the language, I opted to stick it out and wait until I got home.

But standing in the Lisbon airport early in the afternoon of Saturday July 2nd, I realized that things were much worse than I had supposed. I couldn’t stop sweating, I had no appetite, I felt increasingly disoriented, and I was suffering from paracusia, beginning to experience auditory hallucinations. The last time I’d had paracusia had been three or four years earlier when I’d had the flu and had driven with my then-girlfriend from Oklahoma to Rhode Island without adequate sleep, desperate to make it home to my own bed. Maybe it was flu after all, I thought, and then hoped the worst of the symptoms wouldn’t strike until I’d landed.

The Sata airlines flight home seems to me now more of a hallucination than an actuality, in that disconnected and partial way that you (or at least I) remember things when you’re very drunk indeed, as scattered bits and pieces with a kind of absence where you yourself normally reside—a few moments you can cling to, a great deal that’s just lost and may come back later or not at all. I had not been drinking. I had had nothing to drink except water, and very little of that, and nothing to eat for some hours. It seemed a very long flight to me, and I have no memory of the three hour and forty minute stop we took in the Azores, at Ponta Delgada, despite some of the workshop participants on the same flight telling me later that I’d participated coherently in several conversations, that they’d had little sense that something was wrong with me.

I do remember landing in Boston, exhausted, and my then-girlfriend picking me up and then the two of us driving home. I don’t remember if she drove or I did—I suspect the latter since I almost always did the driving, but I can’t be sure. I believe I told her that I’d been feeling poorly, but, as I often did (and still sometimes do), downplayed how ill I actually was.

Once home, I collapsed. Perhaps a night at home in my own bed would be enough to revive me. I slept deeply for a few hours, then restlessly, then not at all. I had a pain in my right side, just below my rib cage, and was having trouble breathing. When I stood, I felt dizzy. I wandered the house delirious as my then-girlfriend slept.

And yet, now that I was back home, despite my experience on the plane, despite what I was feeling, I tried to tell myself it was nothing to worry about. It was as if I could stop myself from being ill just by force of will, by convincing myself I wasn’t ill. When I had been a Mormon missionary decades before, I’d bought a punk cassette which I no longer have and the name of which I no longer remember at a flea market in Marseilles (we were forbidden to listen to anything but hymns as missionaries but that rule, like so many others, I didn’t keep). It included a sung parody of a “diagnostic rite for health,” with someone screaming “I have been ill, I must get better!” over and over again. Early on the morning of July 3rd, I was thinking about this song, repeating it obsessively over and over again in my head as I waited for the sun to rise.

It was Sunday. I did not feel human. The paracusia had returned and it felt like several people were standing just outside of my field of vision, mumbling something that, I began to feel, was about me. Every once in a while, a voice would rise up out of the mumbling, its tones clearer and pitch higher but still not legible. I could recognize it as an individual voice, but could not recognize what it was saying. You’re going mad, I told myself, but another part of me knew I was not going mad, that I was ill, that I had experienced this before, and that once I was better, the paracusia would end.

It was that as much as anything that got me to the doctor—an eagerness to end the auditory hallucinations. I walked down the hill to the end of our street and went right a half block to the clinic located there and then, since I hadn’t realized the clinic opened an hour later on Sundays, and couldn’t face the thought of having to walk back up the hill only to walk down again in an hour, found a place to sit and wait until it did open. When it did, I went in, signed in, waited, signed various forms, waited some more, met with a physician’s assistant, explained what was happening, had x-rays taken, had my blood drawn. I had a fever. There was nothing to be seen on the x-rays. The PA suggested I go home to rest and drink lots of fluids. He told me they’d call the next day with the results of the blood tests.

“Or, well,” he said, “not tomorrow, since tomorrow is Fourth of July. We’ll have results back from the lab on Tuesday.”

Okay, I said, and stumbled home. I tried to sleep. My head felt very hot. The voices were still there. I felt vaguely nauseous and couldn’t stop sweating. I was hardly coherent, but I could fake coherency for brief moments. Maybe I’ll feel better tomorrow, I told myself.

My then-girlfriend had been invited to a Fourth of July party, I no longer remember where, with people who were more her friends than mine. I was invited as well, but I didn’t feel up to going. But was it okay if she went? she wanted to know. I didn’t see much point in her staying, and she clearly was eager to go, so I said yes, even encouraged her.

An hour later, I started vomiting. On one level I felt as sick as I’ve ever felt. On another level, I was so sick, so incoherent, so receded from the surface of my body, that it was as if this was happening to someone else. I did not call my girlfriend, though in retrospect it seems that would have been the best thing to do. At least I don’t think I called her—if I did, she didn’t answer. Instead, I lay there, in the bathroom, vomiting, shivering, with a soaring fever. Sometimes I would manage to make it back to the bed for a few minutes, sometimes not. When she came home, I told her I needed to go to the emergency room—or maybe she was the one to make that decision. My memory of it, the way I tell the story to myself now that we are broken up and haven’t spoken in several years, is that it was the first thing I said to her when she walked through the door.

At the emergency room, things sped up in some ways, slowed down in others. If you are not in danger of bleeding out or flatlining, a good part of your time in an emergency room involves waiting in a curtained-off semi-room as things happen around you. The pain in my side was fairly intense now. I was given some sort of painkiller, I no longer remember what. I was given an ultrasound, but at some point was taken away for a CT scan as well. My heart was now beating much faster than it normally did, laboring, and it would not slow down.

I had, I would eventually be told, a serious infection that had led to a collapsed lung. I had had my appendix out at the same hospital eight months earlier and the doctor’s best guess was that a small fragment of infected appendiceal tissue had not been removed from my body. It had floated through my tissues for months before finally attaching to the top of my liver where it had formed an abscess, which had led to a fistula forming in my thoracic cavity and the cavity filling with fluid, which in turn had collapsed the lung.

Early Tuesday morning they sent me off to have the fluid drained. A man with a thick Rhode Island accent and what, because of some cartoon I watched as a kid, I think of as a sanitation worker’s mustache, pushed a needle deep into my back. The needle was connected by a tube to a large jar which rapidly began filling with pus-like fluid. He filled two jars.

I felt better momentarily, until abruptly I didn’t again. Soon I had trouble breathing. By 10:00 am Tuesday morning, they determined that the cavity had filled with fluid again. They sent me off to have an CT scan so that they could better determine what was happening and how to treat it, telling my then-girlfriend I would be away for fifteen or twenty minutes.

My last memory was of lying on a board as a nurse and a technician tried to position me for the scan. A board? Could I really have been on a board? I started shaking and couldn’t stop. And then I became unresponsive and blacked out.

I woke up surrounded by the concerned faces of half a dozen nurses. I was not in the room I had been in, and did not know how I had gotten to where I was. “There you are,” one of them said, which struck me as a strange thing to say. As I began to come conscious and proved myself capable of responding to questions, several of the nurses visibly relaxed. Soon, all but two of them had moved off to other tasks.

Four hours had passed.

Eventually, I was wheeled back to my room. I had to, or rather felt I had to, calm down my distraught girlfriend, who had been told little during my absence, and so I downplayed what had happened. That had, generally, been my role in the relationship—to be the calm one—and I had learned the role well enough to do it almost by rote, even when I was heavily drugged and it was absurd.

I had only been back in the room a few minutes when my cell phone rang. In an effort to prove that I was perfectly fine, that I had not just almost died, I took the call. It was the PA from the clinic.

“Mr. Evenson?” he said.

“Yes?” I said.

“I have the results of your blood test,” he said. “You have a serious infection. You need to go to the hospital immediately.”

“I’m already at the hospital,” I said.

“Good,” he said. “Thank God.”

I wasn’t sure how to respond to this. When he didn’t continue, I didn’t know what else to do but hang up.

A day or two later, a doctor with no bedside manner would make an incision in my side, drive a hard plastic spike through my ribs, and then thread a tube in, connecting it to a machine that would actively draw the fluid from me. When the spike went in, the fluid rushed out and soaked the doctor’s shoes, and my lung suddenly inflated. It was the single most painful thing I’ve ever experienced, and the remainder of my time in the hospital I spent dreading that they would have to drive another spike in. Months later, I was still having nightmares about it.

I was in the hospital for two weeks in all, during which time I lost 22 percent of my body weight. During the first week, I was sick enough and sufficiently sedated to not be focused on what was going on around me. I could not walk to the end of the hall and back without needing to rest. In the second week, though, I gradually became aware that something else was wrong. My girlfriend seemed to be acting strangely. She struck me as reluctant to be there, fidgeted, seemed eager to be gone. Thinking back, I realized she had been like this even before, on the night she went off on her own to the Fourth of July party, probably even before I left for Portugal. When I finally left the hospital on July 18th, I would discover that she had started searching for an apartment and was planning to move out. We tried to patch things back together, but a few weeks later we would break up for good.

All of that contributed to my frame of mind: the most serious illness of my life to date, an impending breakup, a sense of physical frailty, an inability to focus mentally. My girlfriend came to pick me up at the hospital and then seemed angry that they hadn’t released me by the time she arrived. We only lived a few blocks away from the hospital and I remember—I think this is an accurate memory and not instead a memory from when I had my appendix removed (the two illnesses are linked in my mind since one caused the other)—walking back to the house exceptionally slowly, stopping three or four times each block to catch my breath. But perhaps I only walked to the car.¹

Once home, I moved slowly, like an old man, to our hallway, and regarded myself in the full-length mirror. I had looked at myself in the mirror in the hospital sometimes, but here, at home, looking into a mirror I had looked into often, I could not help but see how much I had changed. So much so that I had difficulty recognizing myself.

•

Looking at myself in the mirror, I found myself thinking of Raymond Carver’s “The Father,” from his 1976 story collection, Will You Please Be Quiet, Please? I hadn’t read that story in probably two decades. And yet, looking over it just a few months ago as I began to work on this book, I discovered that despite the time that had passed, I remembered it almost perfectly.

It’s a short piece, just two pages, more of an anecdote than a story. In it, a family sits around a new baby, engaged in the familiar ritual of attributing parts of the baby to the family member they most resemble. But each time one of them says the baby has someone’s toes, or lips or eyes, the others remain unsatisfied, feeling what has been said isn’t quite right. Until the baby’s sister says, “I know! I know! He looks like Daddy!”

“But who does Daddy look like?” asks another sister. She answers herself a little later, beginning to cry, “Why, nobody!”

And indeed, a moment later, in the unnerving single sentence paragraph that ends the story, we have the father described. “He had turned around in his chair and his face was white and without expression.”

That was what my face struck me as, white and without expression, as if my sense of self had been stripped away, as if I were more the matrix for a being than a being itself, as if I were no longer part of the human race.

•

I’ve thought about “The Father” a lot since then. I first encountered that story when Leslie Norris, the Welsh poet who was my mentor, read it aloud to our class because of a story I had written. Rereading “The Father” thirty years later, I still hear the rich cadences of Leslie’s voice despite the fact that he has been dead for more than a decade. I realized in late 2013, when I was assembling the collection that would become A Collapse of Horses, that I’d had the story in the back of my mind when I wrote “Three Indignities,” despite it being a very different sort of story, about a moment of almost unbearable panic during a medical procedure—one of my few autobiographical stories.

What I admire so much about Carver, particularly in his early collections Will You Please Be Quiet, Please and What We Talk About When We Talk About Love, is his ability to move so rapidly and seamlessly from the ordinary to the uncanny, from the banal to the destructive or debilitative, and to do it with just a few careful strokes. In “The Father” there’s a deliberate shifting of terms: it starts as an ordinarily realistic story, presenting a ritual we’ve all participated in, and only begins to trouble our sense of its realism three-quarters of the way through, waiting to assert itself as a fantastical story or parable until the final line. So you think you’re reading one thing and only discover at the end, from the strange, blank presence of the father in the room, that you’ve been reading quite another.

•

This experience was not unique for me. Indeed, Carver’s work has spoken directly to me at some extraordinary moments and in extraordinary ways. He writes about a peculiar and particularly American form of abjection which, even if I never shared the specifics of it (I never really learned how to smoke and though I now drink I can put it down or pick it up with little effort), I still relate to in other ways. In addition, there’s a great deal that is unexpected about his work if you look closely at it, particularly if you’re a writer. This, as has become clear in recent years, is only partly due to Carver. It is due as well to Gordon Lish, who severely edited his first two books.

I’m not a realist, or rather I don’t care if my work is or isn’t—I’ve made a literary career out of muddying that distinction. That, too, is something that I learned from Carver, even though many of his critics, particularly those who favor his later stories, minimize this aspect of his work. But without this, Carver is a great deal less interesting.

Carver’s work arrived for me at exactly the right moment. My relationship to that work has changed over time, but of all the writers I read when I was first developing as a writer he, more than anyone except perhaps J. G. Ballard, taught me how to write the fiction that I wanted to write.

1. “[N]ot only have I always had trouble distinguishing between what happened and what merely might have happened, but I remain unconvinced that the distinction, for my purposes, matters.” Joan Didion, “On Keeping a Notebook,” in Slouching Towards Bethlehem (New York: FSG, 1968), 134.