Book of the week - The Two Kinds of Decay by Sarah Manguso

‘This is the usual sort of book about illness. Someone gets sick, someone gets well.’ This terse description of her book is the only false note author Sarah Manguso strikes in what is an extraordinarily powerful memoir.  

She was at the beginning of her Twenties when she contracted a rare, paralyzing autoimmune disease. She underwent years of harrowing treatments and even as she got better suffered bouts of depression and steroid-induced psychosis which landed her in a psychiatric ward. Her unusual achievement is not only to battle through this ordeal but to wrench something beautiful and profound from it.

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There’s a searing, unflinching intelligence at work in this memoir. Manguso is always precise and economical, always looking for the concrete example or vivid image; the short, intense chapters – prose-poems really – are spare and understated. Unsettlingly honest descriptions of the treatments she endured, and her reactions to them, are laced with a grim humour, elevating her work from the merely gruesome – and much of it is gruesome.

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She notices everything. She is tougher on herself than some of the medics who let her down, admitting that she did not become a better person for the experience but furious, resentful and spiteful. Sections of this short powerful book read like a thriller or a horror story (‘Sometimes I could hear people  being suctioned. And sometimes above the slurping sound I heard the people yell in pain or in fear at seeing their own dead selves being sucked out of them’).

But she releases the grip at the right moment to provide tender vignettes of those who cared for her or who passed through her life, and musings on time and memory and change.  The later chapters are joyous expressions of overcoming. This is an essential read, never a depressing one despite the subject matter, and it repays several readings. Granta,  £14.99

Words by Kester Aspden

Kester Aspden won the CWA Gold Dagger for non-fiction for his debut The Hounding of David Oluwale.  His next book, Broken English: Memoir of a Troubled Youth, is published by Simon Schuster in Spring 2012