Make ’em bleed

Good​ health connects us with the world, illness forces us back onto ourselves. When Gloria Goltz, the title character of Atticus Lish’s second novel, The War for Gloria, in her early forties, clever, unfulfilled and the mother of a teenager, is diagnosed with the degenerative illness ALS, her life shrinks. Meanwhile her son Corey, who is fifteen when she is diagnosed, both acts as her primary caregiver and rebels against the responsibility, pushed in contrary directions by his growing body and sense of self.

The most rudimentary online search will yield information about ALS (Amyotrophic Lateral Sclerosis, often known in the UK as motor neurone disease and in the US as Lou Gehrig’s disease), enlarging on the grim implications of that word ‘degenerative’ and listing the progressive failure of the body’s systems. A novelist choosing to write about this condition must decide whether to describe it from within the character’s experience or to risk duplicating online searches by adopting a less personal perspective. Lish starts impersonally, with an expository passage more than two pages long that could be quoted from a pamphlet for the newly diagnosed such as the one Gloria picks up at Beth Israel Deaconess. The sentences are pruned of distracting subordinate clauses so as to present the course of coming events with brutal clarity: ‘No one knows exactly what causes ALS. An unknown chemical event triggers a chain reaction that destroys the motor system. The ALS patient will progressively lose function until she is almost completely paralysed. Death usually comes within three to five years, by way of respiratory failure.’

Gloria and Corey live in Quincy, a Boston suburb shrewdly assessed by a subway driver as the home of ‘upper-class poor, lower-class rich’. There’s a sense of knowability unusual in American fiction set in this part of the world, with the way people talk still packed with legible nuance: ‘He was from Brockton and his accent was a rural twist on the East Coast Boston sound of dropped r’s.’ Lish excels at its physical and social geography. There’s a superb portrait of MIT in vacation time, with its empty rooms and unread notices, from the laser-printed addition to the men’s room door that asks ‘Do you want to find a gender-neutral restroom on campus?’ to the flyers for folk-singing and rocketry, and the posters that want to know if you’re depressed or interested in sailing. It’s an exercise in the modelling of negative space as revealing as a Rachel Whiteread sculpture. Lish can produce a sketch of a neighbourhood that is suffused with a character’s point of view, in this case the young and rather overexcited Gloria walking near Commonwealth Avenue: ‘It was a twenty-degree winter’s evening. Brick and limestone architecture, the trolley running down the avenue, frozen air, the burning orange sunset, a frigid cosmic fire, the sense of distance, the turrets of the apartments, the courtyards, gates and gargoyles, the wealthy, the hints of a Jewish presence near Newton, of European immigrants, bookstores and secrets.’ One turning point in the novel is literally that, an awkward turn that causes Corey to rethink his plans at a crucial moment: ‘The Storrow Drive exit demands a sharp, almost ninety-degree turn into the wall of the tunnel, which can feel slightly impossible to execute under the pressure of following traffic. He missed the turn.’

Gloria forfeits the richness of urban and suburban life as the illness inscribes itself in her body, from the early stages when the diagnosis is no more than a terrible prophecy somehow connected to the odd weakness in her fingers, to the time when she can no longer drive or walk and every moment in public space is an ordeal. For the novelist if not the character, serious illness has a lot of richness to offer, an abundance of pressure both internal and external. Even desperate circumstances can leave room for a perspective that is seasoned but not dominated by extremity. The sixty-something heroine of Bernardine Bishop’s 2013 novel, Unexpected Lessons in Love, for instance, is a cancer survivor (like the author), living with a colostomy. Come to that, she can’t help wondering what has ‘happened to her vagina’. But she hasn’t altogether ruled out the resumption of a sex life, remains deeply involved in her family’s doings and continues to intervene in other people’s lives.

A degenerative illness like ALS brings with it something less welcome, an implacable rival narrative. Some such conditions, like multiple sclerosis, can go into remission. ALS does not. How to do justice to this relentless progression without capitulating to it and thereby emptying the novel of every hopeful possibility? The War for Gloria is a strong title, but for much of the book it’s hard for the reader to work out who is fighting it. You could even say that Gloria’s war began and ended on the day of her diagnosis. Novelistic conflict is provided by the antagonism between Corey and his father, Leonard, who has played no real part in his life. Now he stays over at Gloria’s house when it suits him. This astoundingly unappealing character seems to have an empathy deficit that is like a disease in itself, driving Gloria to work one day but not picking her up that evening, leaving her stranded. He keeps her car for a week. She can hardly have many illusions about her ex-partner, but tries not to disparage him to her son, maintaining the fiction that Leonard is somehow studying physics at MIT as well as being attached to the campus police.

Talking to Gloria about her diagnosis, Leonard seems intellectually rather than humanly engaged: ‘Something in the environment sets it off. The fascinating thing is that, mathematically, there has to be a single domino that starts it all. One domino goes down, and it sets off a pyramid effect that takes out everything.’ Those dominoes are her life. You might expect him to soften his manner when talking to his son, but Leonard only plays bullying narcissistic games with Corey:

‘I could tell you a lot about it if I wanted to.’ Leonard basketed his hands behind his head and looked up at their low ceiling. ‘The question is, what are you capable of understanding? There’s no diagnosis for ALS. You can’t see it in the body until someone’s dead. All we have is a name floating around it until you’re in the morgue. A long time ago, a French scientist did an autopsy on a patient and found these hardened neurons in the spine, and gave it a name. His whole contribution is a name. To me, that’s not science; that’s taking a nature walk. It’s like if I went out and pointed up at the night sky and named a star.’

Intellectual contempt is his stock in trade. His confidence in his own cleverness depends on other people being made to feel stupid.

One of the ways Corey deals with his mother’s increasing weakness is to create a tough-guy persona he can hide behind. In time it works so well that it fools even him. He drops out of school, starts intense martial arts training, and improves so quickly he becomes an amateur cage fighter. The psychology here is complex, and includes the yearning to be confronted with a palpable opponent rather than the embodied abstraction of a disease, the need to find a world with unyielding rules, a desire to be punished perhaps, so as to experience a pain distinct from sorrow, and a drive to remove all softness and vulnerability from his own body.

It sometimes seems as if the novel itself is pursuing a similar course and trying to move away from helplessness and its burdens, despite their being its subject. Corey befriends a physics prodigy, Adrian. He too has a mother with a terminal diagnosis (cancer), but he hates her and treats her with contempt. He has an extreme exercise regime, and his fatless physique, described with fascination and a little disgust, helps inspire Corey to develop an armour of his own: ‘His arms didn’t bulge: the bicep and tricep looked like blocks of wood. His body fat was so low you could see the grain in his muscles even at rest … Some of him was beautiful and smooth, and some of him was dirty, pungent, rashy and unshaven.’

Adrian never changes his clothes and has no social skills, so it makes sense that he should establish a rapport with the equally rigid and self-involved Leonard. The two of them make a sort of man-cave on campus, watch pornography together and pool their inadequacies. Leonard even takes a fatherly interest in Adrian, as if to demonstrate that he has those skills but chooses to withhold them from his real son. With all three of its major male characters seemingly in flight from any emotion softer than anger (the easiest negative emotion for men to feel, certainly the most socially sanctioned), there’s real danger of the book overbalancing.

At one point Joan, a lover from Gloria’s past who was a major figure in Corey’s childhood, moves in with the Goltzes. Corey sees her as being ‘at ease in the world in her armour of courage’, but this significantly underestimates her pugnacity. Joan fondly remembers stepping up to a woman who ‘called her out’ although she had the flu. ‘I said: “Bitch, I’m gonna – a-chew!” I sneezed my ass off. I lost. But I gave her a bloody nose. If I get in a fight, I always try to make ’em bleed.’ Even Molly, a neighbour’s daughter and something of a love interest for Corey, is a competitive athlete, strong and fast. At a martial arts event, during which they share the excitement of a fight where one woman kicks another ‘in the lower belly as if she wanted to destroy her reproductive organs’, Corey says to her: ‘I’d be a girl if it’d make me tough as them’ – a joke, but revealing in its suggestion that masculinity itself is only a means to an end, the end being invulnerability.

There’s an oddly touching moment when Corey is overwhelmed by Gloria’s needs, while also maintaining a training schedule of ludicrous intensity, including ‘a conditioning circuit whose goal was to make him throw up. Sometimes it was successful.’ At the weekend he does the laundry, falling asleep at the laundromat during the drying cycle. Then he cleans out the filter of the dryer because he likes ‘the soft, warm, feltlike feel of the lint’. That clump of lint has a lot of work to do in the middle stretches of the novel: it’s just about the only representative of softness and warmth in sight.

Atticus’s father, the celebrated editor Gordon Lish, specialised in cutting Raymond Carver’s stories, sometimes ending them thousands of words earlier than originally written. Eloquent truncation, with the implications left to reverberate, can be a very powerful effect. There were traces of Carver in Lish’s prodigious first novel, Preparation for the Next Life, in scenes where groups of drinking men talk in circles and there are undertones of despair and violence. One section, in which a man who is supposed to meet his girlfriend aimlessly goes drinking instead, could almost qualify as hommage. When she phones to say she has gone home, he protests, the section ending: ‘I was waiting for you, he said. That’s what I’ve been doing this whole time.’ Even so, eloquent truncation isn’t generally well suited to extended narrative. At one point in The War for Gloria Corey hears a crash from the kitchen and runs towards it, finding his mother on the floor. She hasn’t fallen, or not exactly: ‘“I tried to jump!” she screamed in anguish. “I tried to jump one last time.”’ The chapter ends there, but the scene hasn’t really begun – and if we found it easy to imagine the emotions of a fifteen-year-old boy trying to comfort the mother whose illness is gradually taking over his life, The War for Gloria would have that much less reason to exist.

Formal choices can act as lenses or as filters, either concentrating emotion or screening it out. In one scene, Corey assembles a wheelchair that has been delivered, with a cushion custom-made for Gloria, but all the reader is told, before the scene ends with him leaving the house, is that ‘his mother was distressed. She had him hide the wheelchair in the corner and drape it with a bedsheet.’ The choice of paraphrase over more direct narration seems to indicate a reluctance to inhabit that distress, which is hardly compatible with the choice of so painful a storyline. Sometimes Lish renounces any access to what either party is thinking or feeling, as in the scene of profound mutual humiliation in which Gloria chokes on the food Corey is trying to feed her, and he has to clear the blockage with a suction machine: ‘He kicked the motor on and put the wand inside her cheek, vacuuming out the material she was eating. The machine spat it into a clear plastic receptacle attached to the housing, filling it with mucus and pureed peas. Her saliva snapped and rattled in the hose.’ This is as mechanically clear as it is emotionally blank.

Elsewhere there’s a descriptive ecstasy in Lish’s writing that sometimes leads him to pack in more epithets than the grammar can comfortably hold (‘a courthouse faced in marble with Egyptian friezes, clean, sparkling granite, new, bright, smooth, silent, sealed with green glass, running silent silver elevators’). This love of notation for its own sake was part of what made Preparation for the Next Life so impressive, bringing Lish much closer to Updike than to Carver. There were sometimes dozens of place names, T-shirt slogans, brands of goods and graffiti tags on a single page, in an orgy of chronicling that came close to making Updike’s Rabbit books seem (impossible thought) thinly documented, and the geographical range was immense, reaching back to the heroine’s childhood in rural China. Admittedly, Lish’s management of point of view is less disciplined than Updike’s. In The War for Gloria the umbilical cord between writer and character is sometimes stretched too far, as when Lish describes the audience at a fight when Corey is in the preparation area: ‘By now a sea of people was standing in every available space, stepping over folding chairs, eating pizza, drinking beer. One could smell the mustardy tang of the hot dog and pizza concession under the hot yellow lights.’

‘One’, the Princess Anne pronoun, is a rare visitor to contemporary literary prose, not only because of its air of neutral authority – it’s just the sort of thing that makes the editorial blue pencil itch. By disowning subjectivity it more or less disqualifies itself, yet ‘one’ puts in a number of appearances here. When it stands in for Adrian’s point of view, in a description of a classroom, it might conceivably be signalling his alienation from himself: ‘From where he sat, one could see a downward-sloping field of heads.’ That can’t be the case when Lish is describing an intimate scene between mother and son: Gloria ‘lay on the bed on her side, facing out the window with her back to Corey. One couldn’t see out the blinds, but the sun slanted in and one could hear the leaves in the marsh and the birdcalls and feel the air coming in. Her small round head, like her son’s but smaller, lay on the mattress.’ The combination of strongly charged material and artificial distance makes for an odd reading experience. Elsewhere, when Corey’s perceptions are manic if not apocalyptic, Lish feels free to channel them: ‘He felt he had to do something bigger … something so great it could kill him, forcing him to overcome with finality the inner weakness and self-regard that had allowed him to fail everyone around him.’ Why stay away when the feelings are sheerly vulnerable?

Corey’s youth gives the situation an extra pathos, but even an adult caring for a parent is likely to be racked with contradictory emotion. Some writers confront that emotion head on:

whosoever shovels a couple of tablespoons of rose bath salts under the billowing faucet and marvels at their vermilion colour, whosoever bends by hand her sclerotic limbs, as if reassuring himself about the condition of a hinge, whosoever has kissed his mother on the part that separates the lobes of her white hair and has cooed her name while soaping underneath the breast where he once fed, whosoever breathes the acrid and dispiriting stench of his mother’s body while scrubbing the greater part of this smell away with Woolworth’s lavender soaps …

This is a small part of the second sentence, as endless as an American freight train and designed to strike the reader with comparable force, of Rick Moody’s 1997 novel Purple America. Moody, protected by his structural choices, can take the risk of pushing the tone to extremes of banality and grandeur. His whole book takes place on a single day, and so can present a shatteringly vivid snapshot of decline rather than continuous footage, the piecemeal disintegration that makes degenerative illness such an appalling prospect.

Perhaps the only account of such a condition able to include an element of uplift without bad faith is George Miller’s 1992 film Lorenzo’s Oil, starring Susan Sarandon and Nick Nolte as the parents of a stricken five-year-old – this time the acronym is ALD, and stands for adrenoleukodystrophy. Miller’s reputation is largely for inventive action films (The Road Warrior and its Mad Max sequels), but he trained as a doctor and the screenplay he wrote with Nick Enright doesn’t stray far from the facts. It certainly doesn’t short-change the misery of parents watching their son suffer, or soften the monstrousness of obsession and even of mother love. Nevertheless, these parents, Augusto and Michaela Odone (they are given their real names in the film), who had no background in medicine, managed to develop a treatment that stabilised their son’s condition and even produced some slight improvement. But any sense of achievement was overwhelmed by the knowledge that the breakthrough they had accomplished for their son was of more benefit to children in the early stages of the disease. Lorenzo was able to communicate only by blinking and wiggling his fingers, although his life was extended by twenty years.

As Gloria’s radius of engagement and interest progressively shrinks, the balance of Lish’s novel depends on a compensatory enlargement of Corey’s world. His body expands and discovers itself while his mother’s is being reduced to nothing, to ‘tiny guitar strings’ flickering under her skin, ‘the last wires of muscle’. Lish’s prose expresses Corey’s love of the ways the world can be controlled, whether it’s the procedure for closing a marina for winter or the technical terms used in martial arts: he sees ‘future contests in his dreams. If he lost position, he’d shrimp his hips away or Granby and recover guard and immediately go to mission control or the London and work between an omoplata and a triangle. He’d learn to ping-pong between positions, stay one step ahead of his opponent – to never get guillotined again.’

This precise world of human force and human levers could hardly be further from the technicalities of medicine, which describe the invisible breakdowns within the body. In two key passages medical information is both present and suppressed, as if relegated to the book’s unconscious. One comes in a description of the damage Corey risks as a fighter: ‘You could get heel-hooked and wreck your knee. You could get double-leg slammed or suplexed, land on your head, and break your spine. Taking repeated blows to the head could cause dementia pugilistica or, as has been coming to light in football, make one prone to a neurodegenerative disease like ALS.’ In other words, Corey, in his obsessive quest for a world untouched by his mother’s illness, is increasing his own risk of developing ALS. The irony here isn’t subtly glinting but muffled and sidelined. Is he aware of courting this danger? The retreat of pronoun from ‘you’ to ‘one’ suggests not.

The other oblique revelation about the illness and its possible causes comes from a childhood memory. Corey’s grandfather worked for a company that fabricated mechanical parts, which he would dunk in drums of chemicals. Although he wore rubber gauntlets, Gloria told her father not to touch Corey without washing his hands, giving great offence. In narrative terms, though, it’s a huge leap from this anecdote to the statement that follows it: ‘It was possible that the chemicals he had put his hands in had affected his DNA, causing him to pass something on to Gloria that had made her prone to ALS.’ Who says or thinks this? Material like this is the literary equivalent of junk DNA, charged with transformational possibilities but not activated.

To judge by the internal tensions of The War for Gloria, degenerative illness is a bone that sticks in the throat of storytelling, something signalled by the jaunty chapter titles (‘Dopamine Reward’, say, or ‘Gelato’), which have nothing in common with the bleakness of the narrative. It’s the predetermined ending of ALS above all that must somehow be both accommodated and resisted, if death is not to have the last word. Moody’s structural choices allowed him to shift focus drastically after the tour de force opening of Purple America without lowering the temperature. He dramatises a nuclear accident taking place at a local power plant on the same day – not much risk of anticlimax there. Lish struggles to find any such modulation.

Corey and Leonard do not overcome their antagonism. American literature is saturated with damaged fathers and sons looking for each other, to the point where it’s refreshing to read one in which reconciliation isn’t an option. What else might fill the gap? In the last part of the novel Corey has a love affair rendered with a vagueness entirely uncharacteristic of Lish, with someone referred to only as ‘the brown-haired girl’. A theme of self-sacrificial patriotism arrives very suddenly and makes the last pages queasy with unearned uplift. Strangest of all is an extreme genre shift, strongly propelled before being allowed to fizzle, into something like thriller territory, complete with outbursts of coldly described violence: ‘The top of his skull had ruptured. An oval of bone was missing from above the hairline, and a pink bubblegum-coloured tongue of meat had jumped from his head – like a frog shooting its tongue at a fly. The meat was his brain and it had intestinal coils.’ It’s as if both writer and characters leap at the chance to exorcise the frustration born of so much passivity and reluctant openness to pain. For the duration there’s an amnesty on empathy and a release of something like glee when bodies are subjected to a single pulse of annihilating energy, rather than slow-motion disassembly, though the effect is not of development but dislocation. It’s as if Lorenzo’s Oil had ended not with the bleak triumph of the Odones, but with a drawn-out shootout at the lab for possession of the precious oil they developed against all the odds.