Jen Karetnick is the author of American Sentencing (Winter Goose Publishing, May 2016). Her work has appeared in Hospital Drive, Poet’s Market 2013, River Styx, Sou’wester and The Spoon River Poetry Review, and her poems were finalists in the 2010 Knightville Awards and the University of New Orleans Study-Abroad Prize. “Night Sweats” placed second in the Southern Writers Symposium Competition for poetry, and “After” was made into illuminated art and hangs on the wall of the B Bar in The Betsy Hotel, South Beach. She talked to Tell Tell Poetry about her most recent collection. You can purchase a copy of American Sentencing here.
Kallie Falandays: American Sentencing is, in your words, an “intense examination of the female body and the various indignities and ailments from which it can suffer.” What caused you to want to explore these ideas and why do you think they’re necessary right now?
Jen Karetnick: A good number of the poems in this book are about chronic, invisible illnesses, especially those that afflict women and are almost always dismissed by men as “imagined,” “made up” or “hysterical.” Personally, I’ve been ill with autoimmune disease as well as a neuro-endocrine-immune disorder, which some people refer to as Chronic Fatigue Syndrome, an inaccurate name I despise, since I was 24, when I came down with viral meningitis and never got better. For almost two decades afterwards, I’d gone from physician to physician, seeking answers for some really odd, unexplainable complaints, and most of them were men who dismissed my concerns with shrugs, accusations about drug seeking and recommendations to psychiatrists. I would get comments that range from “You look like you’re in great shape, so you must feel well enough” to “You’re a Jewish woman, and Jewish women always complain.”
I was finally diagnosed when, long after I’d given up hope in my early 40s, I was sort of very casually referred to a famous immunologist, Nancy Klimas, who specializes in CFS. I was seriously lucky to be accepted into the practice at a rare time when she had an opening. I’ve since learned that CFS is estimated to affect more than 1 million Americans, many of them women. American Sentencing documents some of the struggle I’ve had with dealing with a disease that you can’t see, can’t prove and can’t treat, mostly because it wasn’t properly categorized from the get-go (back in the 1980s) as a medical problem and thus eligible for research funds from the relevant organizations. So while I don’t particularly like to talk about being sick – in fact, I’d prefer not to be sick at all, and simply have my life back – it’s time to acknowledge that sufferers from this illness aren’t likely to find answers and get better until we start speaking up, raising awareness and bringing the public’s attention – and dollars – to the fact that this very real disease is killing people. These poems are my way bringing attention to CFS in hopes of finding the mechanisms that cause it. That would be the first step toward creating a cure.
These poems also deal with a certain ignorance of disability issues that are rarely discussed in life, let alone in poetry. But the time, I think, has come. We see a lot of poems and acknowledgment about cancer, but not so many about, say, epilepsy. I’m even more convinced that we need honest poetry that doesn’t cringe away from these subjects after reading Adrienne Rich’s obituary in The New York Times. Margalit Fox wrote, “Triply marginalized — as a woman, a lesbian and a Jew — Ms. Rich was concerned in her poetry, and in her many essays, with identity politics long before the term was coined. For Ms. Rich, the personal, the political and the poetical were indissolubly linked; her body of work can be read as a series of urgent dispatches from the front.” Yet only a couple of paragraphs before, Fox had identified the cause of death: “complications of rheumatoid arthritis, with which she had lived for most of her adult life.”
So where is the recognition that Rich was also disabled? That for five or six decades, she struggled with a painful, crippling autoimmune condition, for which there is no cure and, in the end, caused her demise? That she wasn’t triply marginalized but, in fact, had a quadruple set of conditions against her?
Disability of any kind is difficult to acknowledge. I get it. Like admitting that whiteness is a privilege, healthy, able-bodied people simply don’t want to understand how good they have it. And that’s when they can see a disability. You can’t see pain or mental dysfunction – what we call “brain fog” – as a result of illness. Chronic, invisible illness is the ghost of disability: it haunts. If an obvious disability gets the wide eye, then chronic, invisible illness gets the side eye. I want these poems to make it go full frontal.
These poems are seeping with skin and ink and movement. What do you think tethers this collection to our contemporary experiences? What might a 21-year-old male be able to find in this collection?
Granted, a 21-year-old male might not be my target audience. But every 21-year-old male has come from a woman, so my hope is in that reading these poems, he might find some compassion for the one who birthed him, the one (if he’s cis-hetero) who might someday be his partner or the one who could be his daughter. I teach young men, and I have one of my own, and what I like about this generation is their willingness to accept that bodies are messy. They have an easygoingness about sex ed, too, that my generation lacked. I’ve heard teenage boys have conversations with their female friends about periods, and I’ve seen them carry tampons and pads in their backpacks for them and lend them sweatshirts to wear around their waists to hide accidental stains. That’s an unflinching generosity of spirit that wouldn’t have happened in my day, and I applaud the ease in which they share even the unsavory parts of their lives. So perhaps it isn’t too much to expect that a 21-year-old male would be able to relate not only to illness as disability but to how I see periods, pregnancy, childbirth and menopause as a series of illnesses and convalescences, lurking both visibly and invisibly. Which isn’t to say we all suffer from being sick just because we’re female. But it is to point out that we have more to deal with, bodily speaking.
On the other hand, a 21-year-old male isn’t likely to admit to chronic pain or illness, even if he’s feeling it. In general, because of the way our society is structured, men don’t often go to the doctor, even though statistically their symptoms are more readily believed than those of women, until the pain or illness is too much to ignore. Even then, they don’t confide in or rely on friends. I know this also anecdotally from my own husband, who dealt with Ulcerative Colitis for 12 years before he had his colon removed, and from my brother, who sadly passed away in February 2015 from complications with a few autoimmune diseases. So while my work is from a female’s perspective, I think a young man who is not feeling well could identify with it, and if it gets him to a doctor sooner rather than later, then I feel like I’ve contributed to the canon.
How do you think these poems fit in with the trajectory of American poetry? Can you position these poems within a certain vein or style of writing so that we might be better able to understand how we can absorb them?
I read the work of two particular poets on and off when I was writing the majority of this book: Rafael Campo and Lucia Perillo. The former is a physician specializing in HIV and AIDS patients (who have immune problems very similar to CFS patients, if only people would recognize that); the latter suffers from her own autoimmune disease, Multiple Sclerosis, which also runs in my family and which I am constantly being monitored for. They both write knowledgably but in a very real and humanistic way about medicine, health and the body. I think American Sentencing has this same “medic poetic” vibe that also fits in with up-and-coming theories about how medicine should be taught and practiced, and also written about. Medical programs around the country are now offering literary classes and running journals – basically teaching humanities in addition to medicine – because they recognize that it’s literature that adds the human element, the “art,” to the science of medicine. The narrative of patient and physician stories re-sensitizes doctors who, by the end of residency, have become desensitized to people and think of them only as body parts. Many of these journals – Hospital Drive, CHEST, The Intima, The Healing Muse – also solicit from the literary public. Narrative medical writing, from poetry to creative non-fiction, is becoming its own genre, and there are summer workshops and programs for non-physicians as well.
As far as the poetry in American Sentencing goes, it’s a bit on the confessional as well as the clinical side. I’ve been with my husband since he was a pre-med student – he’s now a neurologist – and he says I’m the worst kind of patient to have: I have just enough knowledge about medicine to be dangerous. But although I’m not all about feeling sorry for myself and being sick, I do enjoy discussing medicine from a clinical standpoint. I’ve always enjoyed hearing about his work, and I love diagnosing. I’ve even occasionally helped him parse out a diagnosis for his patients, and I often write health, wellness and medicine articles. (That said, I never could have been a doctor – I would have failed organic chemistry, and the smell of formaldehyde makes me vomit.) We have a mutual admiration society – he loves art and literature and brings home terms and ideas for me that he finds poetic. The first poem I ever wrote involving a medical term was called “Crossing the Blood-Brain Barrier,” which I re-imagined as a way of talking to my grandmother, who had Alzheimer’s and no longer recognized me. That’s not what the term really means, of course. But it spoke to me metaphorically.
Can you talk a little bit about the process of writing this book? What was the first poem that you wrote in this collection and what was the last? What was the organization and publishing process for you like?
The poems actually span the entire length of time that I’ve been ill. I came down with meningitis on my husband’s first day of internship, and he had to take me to the hospital in the middle of the night, hold my hand through a spinal tap, then basically learn how to do one himself. One of the oldest poems in the book is called “The Match,” which is about graduating medical school and finding out where you’ll be doing your internship. It’s a very stressful process, filled with elation and disappointment alike. Some were written through my pregnancies and childbirth years, and my kids are now 15 and almost 18. But most were written in the chunk of time between 2010 and 2015, starting with the time I was finally diagnosed with CFS and began treatment with anti-virals and immune-boosting pharmaceuticals. It’s amazing how much I’ve picked up from immunology team about the immune system and how it works. Truly fascinating stuff. Which leads me to the last poem in the book, “On the Discovery of a Mouse’s Meninges Linking the Lymph to the Central Nervous System,” which is also about the blood-brain barrier. An MD-PhD researcher at the University of Virginia made a discovery this past summer that the brain was indeed connected to the lymphatic system via previously undetected vessels in the sinus cavity. It’s always been thought that the two weren’t connected and that the blood-brain barrier functioned as a gatekeeper. This may not in fact be the case, and the discovery is a game-changer. So I wrote a poem about it.
The forms in the book vary widely from strict villanelles, sestinas and sonnets to really experimental. This is how I feel my illnesses have progressed. Some have been diagnosed with a simple blood test: Hashimoto’s Thyroiditis. Boom. Done. Take Levoxyl. Others are “diagnosis by exclusion” – which means the doctors don’t have a single way of figuring out what’s wrong, so they knock out everything else with a bajillion tests until they’re left with something likely: Irritable Bowel Syndrome. And then there’s lots of experimenting with how to treat it, with sometimes causes other problems – a huge kidney stone, for example, the surgery for which took me almost two years to recover from, because it destroyed my digestive tract and gave me a paralytic ileus. That’s when the poems become fractured, found, erased and put back together again somehow. Some are obviously mournful, such as “Mourning the Body.” Some are resentful, like the ghazal titled “Routine for the Invisibly Ill.” And some are funny or ironic – at least I think they’re funny or ironic – like the one called “Women on the Verge Discuss Viagra.”
What is the most liminal piece of writing advice you’ve ever heard?
Write it down. Don’t rely on your memory because you will forget. Carry a journal and when you think of a good line or come across an interesting term or turn of phrase, jot it on a piece of paper. If it wakes you up in the middle of the night or occurs to you as you’re getting ready to go to sleep, ditto. Don’t allow it to make you an insomniac – a lot of that lucid dreaming stuff doesn’t always make sense – but some real nuggets will pass you by if you don’t note it somewhere. Then, when you’re blocked, you can pull it out and scan for titles, first lines, last lines, etc. Or use them as springboards for ideas. My first poetry professor, the wonderful, late Deborah Digges (there’s a poem dedicated to her in the book as well), called it a “good stuff file.” Keep a good stuff file. You’ll be glad you did.