THE INVISIBLE KINGDOM

Tormented for years by enervating symptoms, the author spent most of her 30s dealing with—and trying to understand—chronic illness.

“To become chronically ill is not only to have a disease that you have to manage,” writes poet and Yale Review editor O’Rourke, “but to have a new story about yourself, a story that many people refuse to hear—because it is deeply unsatisfying, full of fits and starts, anger, resentment, chasms of unruly need. My own illness story has no destination.” Here, the author constructs that story from building blocks of personal narrative and science journalism, with deep dives into the technicalities of the immune system and the microbiome. The personal sections are engaging and well written—“What I had wasn’t just an illness now; it was an identity, a membership in a peculiarly demanding sect. I had joined the First Assembly of the Diffusely Unwell. The Church of Fatigue, Itching, and Random Neuralgia. Temple Beth Ill”—as O’Rourke ably documents her myriad appointments with both Western and alternative practitioners, toting thick stacks of medical records, exploring various autoimmune diagnoses and treatment plans. Some are bizarre and/or dubious, others disgusting but legit (fecal microbiota transplant). Just when the author felt totally lost in the labyrinth of Lyme disease, prescribed the very antibiotics she believed had damaged her body in the first place, she finally found the beginning of a road to health. Though O'Rourke roundly rejects the notion that illness and suffering are somehow balanced by spiritual benefits, her conclusion offers hope. “Today, as a new paradigm for disease is emerging—pushed into full view by the coronavirus pandemic and the epidemic of long COVID—we must amend the simple ‘germ causes disease, body overcomes disease’ model….A holistic, individualized approach to medicine may matter more than was once thought.”

Emotionally compelling and intellectually rich, particularly for those with a personal connection to the issue.