Sarah Manguso’s book may be an outlier-her experiences of pain were transitory and caused by treatments, not the disease itself-but she provides a different perspective on the central topic of this review, metaphor. Three of the four books-Biro, Greenberg, and Heshusius-are primarily about pain. That second language is hard won, and the illness narrative is both the record and the product of winning a coherence that can be called one’s own. But each learns that ill people need a second language that can express what medicine ignores. Each of the authors reviewed here describes the process of learning to speak in terms that physicians can recognize and understand. Medical treatment settings teach patients how to offer medically relevant narrations. Illness narratives sometimes offer direct advice, and they are filled with cautionary tales, but they might be best described as providing a pedagogy of expressive possibility. But for most readers, these books are user manuals for the possibility of coherent experience during times when what happens can defy expression, because conventional expressive possibilities fail to feel true to what the body knows. On a moral level they are acts of witness, telling truths that are too often silenced because they speak of what any sane person would rather ignore among life’s possible outcomes. On a primary level, illness narratives are reports that might be called their ethnographic value. Or, if suffering cannot be integrated into a life, narration allows experience to be held apart as part of one’s life and self. The continuing human need for first-person narratives of illness seems to be this: they offer a language-terms of representation-in which disease, pain, and the often surreal impositions of treatment can be reflected upon, integrated into the life of the sufferer, and shared with others.

The body broken by lynne greenberg