II. Neuro-Medical Imaging and Diagnosis
5. To Be or Not to Be a Patient: Challenging Biomedical Categories in Joshua Ferris’s The Unnamed
© 2022 Pascale Antolin, CC BY-NC 4.0 https://doi.org/10.11647/OBP.0303.05
In Wanderlust: A History of Walking, historian Rebecca Solnit defines walking as ‘ideally […] a state in which the mind, the body and the world are aligned, as though they were three characters finally in conversation together […]. Walking allows us to be in our bodies and in the world without being made busy by them. It leaves us free to think without being wholly lost in our thoughts’.1 However, the pedestrian experience she describes has very little to do with Tim Farnsworth’s own experience of walking in Joshua Ferris’s novel, The Unnamed. A successful Manhattan lawyer, Tim, develops a condition that causes him to walk, against his will, until he is so exhausted that he collapses. No matter how many doctors he consults, the disorder is not identified, let alone treated.
Reflecting on disability in contemporary literature, Stuart Murray writes that ‘[I]n a world governed by new neurological knowledge, any unusual activity can be seen as a syndrome’.2 It is true that since the 1990s, declared the ‘Decade of the Brain’ by President George H. W. Bush, a wide and rapidly expanding spectrum of neuroimaging technologies has become available, resulting in a neuro-technological revolution. Popular books using the findings of neuroscience were published, and soon became bestsellers: the most famous included Consciousness Explained (1991) by philosopher Daniel Dennett and How the Mind Works (1997) by psychologist Steven Pinker. They propounded neural theories of mind and explained mental phenomena in terms of brain processes. Since then, not only has neuroscience developed but its application to fields beyond medicine has been widespread. Literature is one of them, hence the emergence both of the ‘brain memoir’3 and of the ‘neuronovel’ (Roth), or ‘syndrome novel’ (Lustig and Peacock), or ‘neuronarrative’4 (Jonhson). ‘Both genres engage brain research, translating neurobiological theories into literary experiments’.5 The neuronovel—and I will use this word for the sake of simplicity—draws on neuroscience and, often, neurological syndromes, to explore the complex relations between body, mind, self, and world. In the introduction to Diseases and Disorders in Contemporary Fiction, T. J. Lustig and James Peacock write that most syndrome novels rely on ‘the heightened presence of scientifically-defined conditions’6—Tourette’s in Motherless Brooklyn, Capgras in The Echo Maker, amnesia in Man Walks into a Room, to quote only a few. Like all these books, The Unnamed ‘vividly illustrates the contemporary fascination with both the workings and the sciences of the mind’.7 But Ferris’ narrative stands out because Tim’s condition is never ‘scientifically-defined’. It challenges medical classifications and clinical expertise. Hence, the protagonist turns into ‘a medical orphan’,8 that is, a patient—in the etymological sense of the word, from the Latin patior, pati, to suffer—without any clinically based diagnosis.
According to Annemarie Golstein Jutel, ideally,
[t]he diagnosis provides structure—sorting out the real from the imagined, the valid from the feigned, the significant from the insignificant, the physical from the psychological. Once the diagnosis is made, the concordant treatment can be planned, the prognosis reflected on, and resources allocated […]. The diagnosis is both rudder and anchor: its pursuit guides the individual to the doctor’s consulting rooms, while its assignment positions identity and behavior.
Being diagnosed gives permission to be ill.9
In Ferris’ novel, Tim is denied this permission, and thereby he is doomed to the chaos created by his condition. It consumes his life, erodes his personal and social identities until it destroys him altogether. It is true that diagnosis—of a chronic illness, in particular—is also likely to disturb and ‘rearrange individual identity, threatening previous self-definition as the individual now “inhabits” an illness’.10 In his memoir, When Breath Becomes Air, for instance, neurosurgeon Paul Kalanithi describes the moment when he was diagnosed with cancer ‘as if a sandstorm had erased all trace of familiarity’.11 In Ferris’ novel, however, a diagnosis could also have provided Tim with a new identity, the collective identity that brings together all the patients suffering from the same disease.
Instead, Tim’s sickness is never conferred legitimacy: ‘when a doctor deems a patient’s condition to be medical, the latter receives previously unauthorized privileges such as permission to be absent from work, priority parking, insurance benefits, reimbursement for treatment, or access to services’.12 Tim’s condition remains an illness, that is, a personal experience of sickness, and it is never recognized as a disease, i.e., ‘what Western medicine considers biological or psychophysiological dysfunction’.13 In other words, Tim never becomes a patient in the medical sense of the word, as he does not experience the ‘narrative surrender’ mentioned by Arthur Frank in The Wounded Storyteller, that is, ‘surrendering oneself to the care of a physician […] [who] becomes the spokesperson for the disease’.14 Tim is left to ‘the isolation of his […] suffering’,15 as he loses his job, his wife, and his family, and eventually finds himself alone walking across America. Goldstein Jutel explains that the doctor’s inability to explain the symptom shifts responsibility to the patient, ‘positing the cause [of the condition] as the patient’s mental health’.16 But this is a responsibility that Tim declines in an early passage where his wife, Jane, is the focal character:
The health professionals suggested clinical delusion, hallucinations, even multiple personality disorder. But he said, ‘I know myself’. He said, ‘I’m not in control, Jane’. His mind was intact. His mind was unimpeachable. If he could not gain dominion over his body, that was not ‘his’ doing.17
The passage discloses Tim’s denial of a psychological origin to his disorder. It also prefigures his increasingly disrupted sense of self, and the split between his body and his mind, which is one of the major themes of the novel.
While materialist or reductionist conceptions have developed since the 1990s, producing a view of the self as no longer free but determined by brain processes—with Joseph LeDoux’s ‘synaptic self’ and Nikolas Rose’s ‘neurochemical self’ as significant examples—other neuroscientists ‘take the position that we don’t know enough yet, but we will one day. Literary writers tend not to engage the debate so much as use it as a source for material. The unresolved debate makes space for the literary representation of the relation between matter and mind’.18 This ‘representation of the relation between matter and mind’ is at the heart of Ferris’ The Unnamed. Challenging the materialist view of the self in particular, the novelist shows to what extent the relations between body, brain, and mind are anything but simple or stable, particularly in critical moments such as Tim’s undiagnosed condition. According to Tanja Reiffenrath, ‘many illness narratives elucidate that particularly in moments of crisis, the congruence body/brain and mind is contested and often re-conceptualized in a dualist fashion’,19 which leads her to analyze Ferris’ novel in the light of Cartesian dualism. As for Nathan D. Frank, he argues that ‘even if we decide that neurology does not directly apply to The Unnamed’s disabled Tim Farnsworth, it provides enough of a meditation on what neuroscience could mean for the protagonist that any other interpretation will be colored by these potential ramifications’.20
The degradation of Tim’s health is highly suggestive of the embodied chaos described by A. Frank in his exploration of illness narratives: ‘The chaos story presupposes lack of control, and the ill person’s loss of control is complemented by medicine’s inability to control the disease’.21 It is true that A. Frank analyzes illness memoirs rather than fiction, but the dramatic disruption of Tim’s sense of self is also represented by an increasingly chaotic, fragmented narrative form. This strategy is a powerful means for Ferris not just to suggest the deterioration of Tim’s condition mimetically, but also to question categories. As chaos prevails indeed, traditional references and conventions—whether medical, lexical, or literary—are necessarily disrupted and questioned.
While in his famous 2009 essay, ‘The Rise of the Neuronovel’, Marco Roth argued that in the neuronovel the brain has replaced the mind, in Ferris’ book, by contrast, it is the body that threatens the mind, while the missing name of Tim’s sickness creates chaos. This essay will thus focus on the challenging of medical knowledge, of neurological reduction, and of social and literary categories.
Challenging Medical Knowledge and Classifications
At the beginning of the novel, when Tim is working at his desk one night and the lights in his office switch off, he experiences the moment as a ‘re-entry into the physical world. Self-awareness. Himself as something more than mind thinking’.22 This episode is not the first instance where the dichotomy between Tim’s body and his mind has been mentioned in the novel. However, it is a very special moment: as Tim becomes aware of his body again,23 he seems to feel whole and happy. The short sentence ‘That was happiness’24 concludes the episode.
A few minutes later, Tim is faced with a brutal crisis: ‘He looked back at Peter, who stood in the doorway, but his body kept moving forward’.25 The dramatic last sentence signals the end of the congruence between body and mind—with the ‘body’ as the subject of the sentence—and the return of Tim’s alienating condition. However, the extract is not followed by a description of Tim’s compulsive walking—as often happens in the novel—but by an analepsis, instead, where Tim remembers a doctor’s words in direct speech, as if they were so unacceptable that he had been unable to appropriate them: ‘“There is no laboratory examination to confirm the presence or absence of the condition, […] so there is no reason to believe the disease has a defined physical cause or, I suppose, even exists at all”’.26 The juxtaposition on the same page of the disorder and its denial by a doctor27 exposes the limits of the empiricist frame of reference. Besides, the doctor’s words exemplify what Goldstein Jutel describes as the doctor ‘shift[ing] responsibility (for the inability to explain the symptom) from the doctor to the patient’,28 who is not just denied credibility but turned into a fraud. While the doctor’s name Regis—from the Latin, rex, regis, king—corroborates the authority of his words, the passive form, by contrast, describes Tim’s reception of the message: ‘I was told’.29 The phrase ‘there is’ turns the doctor’s opinion into a universal statement. It also represents the objective third-person of scientific discourse, even though it is ironically challenged by the subsequent comment clause, ‘I suppose’, disclosing the doctor’s logic and conclusion as unscientific. What the passage especially reveals is Tim’s doctors’ refusal ‘to conceptualize the disease in other than physical, neuroscientific terms’.30 Since the first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-I) in 1952, the mind has been increasingly medicalized. However, it was in 1980, with the publication of DSM-III, that the ‘biomedical syndrome’ emerged and ‘the Age of the Syndrome began’. Since then, ‘mental illnesses [have been] diseases of the brain or central nervous system’.31
Whenever the different physicians Tim has consulted are mentioned in the narrative, their names and more or less preposterous diagnoses and treatments—re-enacting his birth, for instance, or ‘seven days of colonics and grass-and-carrot smoothies’32—are listed in disorderly fashion, thus highlighting Tim’s confusing experience as a medical orphan. This confusion is enhanced syntactically either by long sentences,33 where medical doctors and healers are lumped together as equally ineffective, or by very short, fragmented paragraphs34 underlining their diverging views. The confusion reaches a climax, paradoxically, when Tim is eventually given a diagnosis by a doctor aptly named Klum,35 whose medical specialty is not specified: ‘benign idiopathic perambulation’.36 With their Greek or Latin roots, the three increasingly long, polysyllabic words debunk the medical authority since they convey no meaning at all, and merely amount to an admission of impotence. As Tim repeats them to himself, they are italicized, thus turning into signifiers without any signified, which Tim can even play with: from ‘idiopathic’, for instance, he coins ‘idiopaths’. No wonder that the list of doctors in that particular passage should end up with a quack, a ‘genealogical healer’.37
Another doctor then offers to take a ‘clean image of [Tim’s] brain […] in situ’38—resorting to Latin words again—using a prototypical headgear equipped with sensors to register Tim’s brain activity. But the device is strangely ambivalent. While it is described in highly emphatic terms, it looks very pedestrian: ‘It had been retrofitted to perform an extraordinary purpose and manufactured exclusively and at great expense, but he wondered how such an everyday object could serve to advance an understanding of his mystery’.39 The grandiloquence suggests both the doctor’s confident speech—as he talks Tim into trying the latest technological development—and maybe Tim’s renewed hope of a diagnosis. Ironically, however, ‘the very medicalization that would “exonerate”40 Tim Farnsworth is also the institution that brands and stigmatizes him to the point that he must evade and deflect social inquiry […] thus a shaved head and a curious helmet deploy Tim’s liberation as his non-liberation […]’.41
All the passages dealing with Tim’s doctors, therefore, are highly critical of medicine and its classifications. For instance, they tend to focus on the debates surrounding psychiatry and neurology,42 and pit them against each other:
The psychiatrists believed his situation came from a physical malfunction of the body, something organic and diseased, while the neurologists pointed to the scans and the tests that revealed nothing and concluded that he had to be suffering something psychological. Each camp passed the responsibility for his diagnosis to the other, from the mind to the body, back to the mind […].43
It is even Tim’s psychiatrist who recommends ‘genealogical healing’,44 when she realizes she cannot make sense of his condition. In most cases, exaggeration and irony are used to arouse suspicion of doctors’ scientific expertise, and undermine the medical authority. Ferris’ physicians also propose diagnoses and treatment methods that are as ludicrous as those suggested by healers and gurus—the headgear that looks like a bicycle helmet, for instance—and, thereby, they all find themselves on an equal footing, equally disparaged. Eventually, to conceal the limits of their knowledge, doctors put the blame on Tim—either the disorder ‘is something all in [his] head’45 or he is a freak of nature, with an unheard-of condition. The failure of the headgear to produce any results also shows the limits of the neuro-technological revolution.
This episode of eccentric neuroimaging is somehow reminiscent of the ‘pivotal event’ in the Naturalist novel, as it was defined by Frank Norris in his 1901 essay, ‘The Mechanics of Fiction’: ‘It is the peg upon which the shifting drifts and currents must—suddenly—coagulate, the sudden releasing of the brake to permit for one instant to labor full steam ahead. Up to that point the action must lead; from it, it must decline’.46 This new failure of medicine literally concludes a chapter in Tim’s life, and in the novel. From then on, he no longer seeks a diagnosis or treatment, that is, he no longer seeks help from outside—particularly from doctors—hence the beginning of part two with its ominous title, ‘The Hour of Lead’,47 borrowed from Emily Dickinson’s poem ‘After great pain, a formal feeling comes—’.48 The failure of the headgear represents the beginning of a significant process of degradation in Tim’s condition and life that will end with his death. However, the three parts that follow this failure in Ferris’ novel do not show the ‘increase in speed’ mentioned by Norris as a result of the pivotal event.49 The structure of The Unnamed is far more complex, therefore, than that recommended by Norris for a Naturalist novel. Ferris both borrows tools, and departs, from that tradition and its sympathy for medicine—as evidenced by Claude Bernard’s influence on Emile Zola, for instance.
In the opening pages of part two, Tim has lost his job as a lawyer and his big office; he has also given up hope of ever receiving a diagnosis, let alone a cure. Therefore, he turns his back on medical expertise, and takes matters into his own hands, so to speak. As he has failed to find a ‘spokesperson for [his] disease’,50 Tim starts to describe his condition in his own words,51 and his self is increasingly reduced to the binary of the body and the mind.
Challenging Neurological Reduction
Early in the narrative, Tim’s condition is described by his wife, in a chapter where she is the focal character, as ‘a hijacking of some obscure order of the body, the frightened soul inside the runaway train of mindless matter, peering out from the conductor’s car in horror’.52 The description is suggestive of the traditional metaphor of the body as machine, dating back to Descartes’ Traité de l’homme (1648). Tim’s disorder seems to have taken control of his body from inside, while he has turned into a powerless spectator in a modern tragedy. The same figurative language is used in another passage focalized by Tim: ‘He looked down at his legs. It was like watching footage of legs walking from the point of view of the walker. […] the brakes are gone, the steering wheel has locked, I am at the mercy of this wayward machine’.53 Here Tim’s confusion is underlined by the shifts from the past to the present tense, and from the third to the first-person narrative. However, the metaphoric representation evolves in the following passage: ‘His body wouldn’t be contained or corralled. It had, it seemed, a will of its own’.54 Here, ‘corralled’ suggests a wild animal, instead. Tim also moves from the image of one entity manipulating another from inside to a fight between two independent opponents: ‘his body […] spoke a persuasive language of its own […] these two opposite wills worked to gain the better of each other in a struggle so primitive that it could not be named’.55
The primitive struggle is reminiscent of Robert Louis Stevenson’s Dr Jekyll and Mr. Hyde56 (1896) and Frank Norris’ Vandover and The Brute, written around 1894–1895, but only published posthumously in 1914. These novels stage forms of dualism—suggested by their titles—as they take up the image of the beast within the civilized man. While Stevenson’s brute emerges under the influence of a drug, Norris’ beast appears as a consequence of mental illness. Vandover, the eponymous hero, suffers from lycanthropy and, as each crisis develops, his perception of himself changes: ‘His intellectual parts dropped away one by one, leaving only the instincts, the blind unreasoning impulses of the animal’. Norris does not mention Vandover’s mind or any resistance on the part of his character’s intellect, and the ‘beast’57 prevails. By contrast, resistance is always present in Ferris’ narrative, as suggested by the following passage: ‘He continued to think, “I’m winning,” or “Today, he won,” depending on how well his mind, his will, his soul (he did not know the best name for it) fought against the lesser instincts of his body’.58 While the word ‘instincts’ features in both extracts, Ferris’ protagonist also expresses ‘a yearning to achieve some transcendent spiritual meaning presumed to be absent from the postmodern world’59—as suggested by the evolution from the mind to the will to the soul. Ferris borrows from nineteenth-century naturalism to question contemporary materialism, as they both deny the mind and free will: ‘[Tim] revolted against the disproportionate power enjoyed by chemical imbalances and shorting neural circuits. He could say the words “autonomic nervous system,” whereas the autonomic nervous system just was; therefore, he was superior to the autonomic nervous system’.60 From beginning to end, his hero clings to his mind as self and dismisses his body. Tim’s position, however, is paradoxical: on the one hand, he adheres to the traditional mind/body dualism against contemporary reductionism; on the other, he denies mental illness as the cause of his condition.61
Tim’s view of his body changes dramatically in the second part of the novel. While his body turned on him when he first experienced the disorder, Tim now turns against his body. He no longer blames his legs for the compulsory walking, but sets himself against his whole body, which becomes a synecdoche for his condition. Since no sick part can be identified, the whole body is rejected, or I should say, ‘ab-jected’. This approach indeed brings to mind Julia Kristeva’s theory of the abject:
There looms, within abjection, one of those violent, dark revolts of being, directed against a threat that seems to emanate from an exorbitant outside or inside, ejected beyond the scope of the possible, the tolerable, the thinkable. It lies there, quite close, but it cannot be assimilated. […] And yet, from its place of banishment, the abject does not cease challenging its master.62
Tim cannot get rid of his body, he can only ‘abject’ it, because it is part and parcel of who he is—it even prevents him from committing suicide.63 With a diagnosis, the abject would have been located in one body part, and framed. Instead, Tim’s abject body testifies to his attempt to distinguish between sick and healthy without the tool of diagnosis. Tim’s split self, therefore, represents his desperate effort to define his self merely along the lines of his thinking mind, without the threat that his alien body poses to his identity.
As the novel unfolds and the gap between body and mind widens, Tim experiences a sort of descent into hell with a tragic decline of his mental health. First, there is the ‘constant fear of a recurrence’64 throughout the second part, and then the relapse in part three: ‘His body moved him down the sidewalk’,65 which is highlighted again by the reversal of the traditional roles of subject and object. In the same chapter, Tim calls his wife and says: ‘“Well, I’ve fed the son of a bitch” […] “I’ve fed the son of a bitch and now we are standing outside the mini-mart” […] “We’re feeling better” […]’.66 The major shift in narrative persons—from the first-person singular to the first-person plural—signals Tim’s loss of a unified identity, and his dramatic recognition of the presence of ‘the other’ for the very first time. In the struggle for control that follows, Tim always tries to resist and weaken his body: ‘The other stopped saying food, food, and started saying leg, leg—but he continued to eat the doughnuts and ignored him’.67 The war between Tim’s mind and his body also turns into a war between the syntax of a narrative self and the parataxis of instinct, stressed here by the repetitions.
At this stage, the narrative, too, undergoes a dramatic evolution as it starts mimicking Tim’s increasingly degraded (mental) health. Not only are the last three parts in the novel significantly shorter than the first—a sign of the protagonist’s more and more fragmented self—but, in part four, the chapter division disappears, only longer and shorter paragraphs remain, and down to the end Tim is nearly the only focal character. The novel has turned into ‘a chaos narrative’.
Challenging Social and Literary Categories
The phrase ‘chaos narrative’ is used by A. Frank to refer to personal narratives of illness that are so ‘threatening’ they can hardly be told.68 According to Frank, in these narratives,
the body is so degraded by an overdetermination of disease and social mistreatment that survival depends on the self’s dissociation from the body, even while the body’s suffering determines whatever life the person can lead. […] A person who has recently started to experience pain speaks of ‘it’ hurting ‘me’ and can dissociate from that ‘it’. The chaos narrative is lived when ‘it’ has hammered ‘me’ out of self-recognition.69
While The Unnamed is not an illness memoir, the experience of ‘chaos embodied’70 described by A. Frank has a lot in common with Tim’s own experience. ‘But’, A. Frank adds, ‘in the lived chaos there is no mediation, only immediacy’.71 This maybe one of the reasons for the use of an omniscient third-person narrator in the novel: it allows for some critical distance to prevail throughout. While zero focalization72 is employed occasionally, Ferris mostly uses the main characters as focalizers—Tim especially, as well as his wife Jane and their daughter Becka—giving the reader access to both the sick protagonist’s and his family’s viewpoints and emotions. Each of them focalizes specific chapters, in disorderly fashion, down to part three, where only the first chapter is focalized by Jane, and part four, where Tim is the main focalizer. From then on, the representation of his degraded mental health turns increasingly dramatic—as testified, for instance, by the body’s repeated intrusions into the narrative: monosyllabic words73 at first, ‘then progressing to simple sentences (“Leg is hurting” [213]) and sarcasm (“Deficiency of copper causes anemia, just so you know” [216]) before arriving at full-blown taunting […] [Ferris 223–24]’.74 Other no less dramatic strategies are also employed to elucidate these intrusions: a fill-in-the-blanks passage,75 dramatic dialogues76 and recurrent typographic variations.77 The distorted text turns into a mirror image of Tim’s increasing mental alienation. But his body’s growing decay is nevertheless documented, particularly by the use of parataxis and long lists of more or less serious ailments, equally intruding upon the narrative: ‘He had renal failure, an enlarged spleen, sepsis-induced hypotension, cellular damage to the heart. He had trench foot and a case of dysentery. He required assisted breathing and intravenous antibiotics’.78 Tim seems to enjoy these dry lists of medical names as they contrast with the absent name of his major condition and represent rare moments when his body can at last be labelled and classified. Ferris’ novel, therefore, combines a mostly conventional narrative strategy with experimentation and fragmentation in the concluding chapter. As Tim is denied the ‘narrative surrender’79 experienced by patients who have been given a diagnosis and fails to speak for himself at the beginning of the second part,80 literature—that is, Ferris’ The Unnamed—seems to take over and offer at least a successful narrative for Tim’s condition, if not a diagnosis.
However, the end of the book does not bring about any clear resolution, as suggested by the last sentence and the conflicting interpretations it has provoked: ‘the exquisite thought of his eternal rest was how delicious that cup of water was going to taste the instant it touched his lips’.81 It seems to bring body and mind back together through the co-presence in the sentence of ‘thought’ and ‘lips’. Chingshun J. Sheu argues that Ferris ‘manages to grant victory to both mind and body without uniting them: his mind keeps working after physical death, but its last thought is of a “delicious […] cup of water” [310]. Mind and body are two, but indivisible’.82 But Reiffenrath considers that ‘the protagonist is indeed able to win the protracted war against his body’.83 These diverging views highlight the ambiguity at the heart of the narrative,84 and the author’s disruption of readerly expectations and literary conventions alike.
For instance, while the title of Ferris’ novel seems to refer to his protagonist’s unnamed condition, it is also an allusion to Beckett’s novel, The Unnamable (1953), as Ferris himself confirmed in an interview.85 Ironically, while Beckett’s narrator-protagonist cannot move, he is affected by another compulsion than Tim: he cannot stop talking. As for the intertextual allusions to Dickinson’s poetry in the titles of the four parts, they are programmatic since the poem leads the reader from the disorientation provoked by loss to death. They also yoke the contemporary (neuro)novel with nineteenth-century poetry, a poem moreover which neither follows a regular rhyming scheme nor a regular metric pattern, in other words, a poem questioning conventional poetic rules. The Unnamed also borrows from detective fiction, a recurrent feature of the neuronovel,86 but it is only a subplot, playing a minor role in the narrative.
The dramatic degradation of Tim’s health and of his personal and social lives is reminiscent of the Naturalist novel, too—as seen earlier. Tim’s return to a primitive life in the wilderness, in particular, recalls the eponymous character’s departure from San Francisco after the murder of his wife in Norris’ 1899 McTeague. However, Tim’s wilderness has nothing to do with McTeague’s, or even the mythical American wilderness, as evidenced by the opening lines of part four: ‘everywhere was a wilderness to him who had known only the interiors of homes and offices and school buildings and restaurants and courthouses and hotels’.87 What is suggested here, and underlined by the polysyndeton, is that, no matter how successful, Tim’s whole life relied on a fundamental loss, both of meaning and traditional references. This is confirmed in a scene at the bank late in the novel, when the protagonist has supposedly returned to a primitive life:
When the banker took him back and accessed his portfolio with the various websites and passwords he’d been given, he saw an inordinate amount of money diversified across a wide spectrum of investment vehicles. This caused him to turn away from his computer screen and stare at the man across from him. His foot was perched on the edge of the desk and he was picking dried blood from his leg and collecting the flakes in the palm of his hand. The banker fished the garbage pail out from under the desk; ‘Do you need this?’ he asked.88
The emphatic evocation of the data on the computer screen—that is, of Tim’s wealth—stands in sharp contrast with the grotesque description of the protagonist as a sort of tramp ‘in a soiled T-shirt and ripped chino’,89 sitting across from the banker, with his foot on the desk. Despite the circumstances, Tim’s body language suggests that he has remained a hegemonic white male, so that the American myth of the return to a primitive life in the wilderness is completely distorted. The passage also elucidates the reason for the presence in the novel of numerous episodes and anecdotes about Tim’s corporate life. They draw a satirical portrait of urban professionals and the American work ethos.
Tim’s profession as a successful lawyer suggests the power of civilization—with the law as the bedrock of the social contract. This is confirmed in a passage focalized by Jane, where she imagines Tim at work: ‘she could still picture him in a climate-controlled conference room […] drinking civilized lattes and assessing the other side’s evidence. It was what he wanted, this corporate pastoral’.90 The first hypallage (or transferred epithet) ‘civilized lattes’ showcases the association, in Jane’s mind, of civilization with a safe, indoors environment peopled with rational beings. As for the second hypallage, ‘corporate pastoral’, it highlights the subversion of the pastoral ideal91 in contemporary American society. This subversion is also illustrated incidentally by Lev Wittig, a former partner at Tim’s law firm, who needs a snake in the room when he has sex, because this is how he gets excited.92 As for Mike Kronish, another partner, he is such a workaholic that his children hardly ever see him and end up calling him ‘Uncle Daddy’.93 Episodes of this kind are scattered in the novel, and challenge both the ‘perfect’ appearance of Tim’s corporate life, the so-called rational beings surrounding him, and the very notion of civilization they supposedly embody as lawyers. To a certain extent, the novel creates a parallel image of doctors and lawyers as illusions of civilization.
Eventually, Tim’s condition questions the concept of disability as his (compulsive) walking can be associated with the figure of the flâneur originating in nineteenth-century Paris,94 and Ferris said in an interview that he had the flâneur in mind when he wrote the novel.95 According to David Serlin, however, disabled bodies are usually excluded from the literature on flânerie because
the embodied experience of disability challenges and even thwarts cultural expectations of the firm division between public and private spheres. […] The disabled flâneur visibly alters perceptions of public space by exposing that which has typically pertained to the ‘interieur’—visible bodily differences as well as the invisible effects of institutionalization or, in more contemporary circumstances, networks of care giving and mutual support—to the outside world in ways that are anathema to narratives of modern autonomy.96
By setting his disabled character in a modern urban landscape—at least at the beginning of the novel—Ferris also destabilizes ‘the apparent position of power of the male figure in the city of modernity’.97 By becoming a flâneur, Tim falls out of the corporate order and into the feminized field of the inactive and dependent.
Disability is traditionally associated with inferiority and feminization,98 deficit, absence and loss.99 The challenge of disability is evidenced in particular by Jane’s description of Tim’s body when they are about to make love, after one of his compulsory walks: ‘She felt all along his lean walker’s body, the legs that were all muscle now and the torso that had slimmed down to the ribs as if he were a boy again’.100 Tim’s condition here does not involve deficit and loss but, instead, muscle gain and rejuvenation. His boy’s body, however, can also suggest a loss of virility, and the feminization mentioned by Rosemarie Garland-Thomson. A white protestant male and a successful professional, Tim initially stands for the ‘normate’, as it is defined by Garland Thomson: ‘The term normate usefully designates the social figure through which people can represent themselves as definitive human beings. Normate, then, is the constructed identity of those who, by way of the bodily considerations and cultural capital they assume, can step into a position of authority and wield the power it grants them’.101 While his compulsive walking disables Tim, both physically and socially, ‘it revolves around walking, the paradigmatic act of ability in popular culture, as connoted in the phrase “to stand up and walk.”’ Tim is ‘able-bodied—in fact, we might say he is “over-able.”’102 Both ‘over-able’ and disabled, normate, and deviant, wealthy and homeless, a lawyer, and a tramp, Tim defies social categories and turns into a figure of resistance in the context of the American capitalistic society.
At the end of the novel, his ailments are so numerous that, paradoxically, the diagnostic list tends to exceed the disability category. Tim is no longer ‘over-able’ but overly disabled, so to speak. His compulsive walking seems to have taken a back seat as he is diagnosed with ‘conjunctivitis’, ‘leg cramps’, ‘myositis’, ‘kidney failure’, ‘chafing and blisters’, ‘shingles’, ‘back pain’, ‘bug bites, ticks, fleas and lice’, ‘sun blisters’, ‘heatstroke and dehydration’, ‘rhabdomyolysis’, ‘excess [blood] potassium’, ‘burning tongue’, ‘head cold’, ‘pneumonia’, ‘pleurisy’, ‘acute respiratory distress syndrome’, ‘excess fluid [in] his peritoneal cavity’, and ‘brain swelling’.103 The proliferation of signifiers may suggest an ironic attempt to compensate for the lack of the major signified—the name of Tim’s condition—and at last provide him with the ‘empirical evidence […] [of] a legitimate physical malfunction’104 he has been desperately looking for for years.
While disability is questioned,105 Ferris’ The Unnamed, however, ‘leads to the “lesson” of syndrome novels: that the body/brain interface […] is more enigmatic than lawyers can imagine and even scientists explain. Or, to quote Emily Dickinson, […] “the brain is wider than the sky.”’106 Ferris thus seems to delight in blurring traditional categories: not only is the body said to have ‘a mind of its own’107 but, in the end, ‘the soul is the mind is the brain is the body’.108 The passage certainly illustrates Tim’s degraded mental health, but it also suggests that ‘the relationship between brain and self’—or brain and soul and body and mind—remains ‘a fascinatingly complex conundrum’,109 as Tougaw writes. The repeated allusions to the soul in the narrative could suggest resistance to ‘biology and strict materialism’110 and ‘a partial return to religion and spirituality’111—as in Jonathan Franzen’s essay ‘My Father’s Brain’. But Tim’s views on the soul change throughout the novel, depending on the circumstances. First, his conception of the soul seems uncertain—‘[…] his mind, his will, his soul (he did not know the best name for it)’112—then he announces that ‘there’s no soul […] No God’,113 before changing positions again when he is faced with his wife’s cancer: ‘The soul was inside her doing the work of angels to repulse the atheistic forces of biology and strict materialism’.114 Stephen Burn interprets these conflicting views as ‘Ferris’s exploration of the novel’s dialogic capabilities simultaneously to endorse the authoritative languages of “chemical imbalances and shorting neural circuits” and the most mystical “work of the divine” (214, 305)’.115 Tim’s diverging positions also illustrate Ferris’ challenge of conventional binaries—religion or science, health or disability, the body or the mind—as his unnamed disorder questions categorization. They show Ferris ‘explor[ing]’ the power of language and the novel to promote inclusion over exclusion, ‘synthesis over rupture, compromise over raw polarities’116—a characteristic, Burn argues, of the contemporary syndrome novel. In the end, considering the limits of medicine, literature emerges as an alternative solution to make sense of illness.
A syndrome novel staging a character without any diagnosed syndrome, The Unnamed stands apart, and challenges the (sub-)genre from the start. It is ‘precisely because Tim Farnsworth’s condition can be read as mental and/or as physical, as neurological and/or as non-neurological, [that] The Unnamed sets up as a radically individuating novel […]’.117 With his hero’s undiagnosed disorder, Ferris also questions medical classifications, and his doctors turn out to be as powerless, even pathetic sometimes, as the quacks his hero has also consulted. No matter what medical experts may say, however, Tim denies the materialist conception of the self to such an extent that he rejects or ‘abject[s]’ his whole chaotic body. But the blank at the heart of the narrative disturbs traditional references and questions social categories—particularly disability and health.
As for Ferris’ introduction of the soul into his fiction, it suggests both a strategy of resistance to the ‘totalizing claims of contemporary neuroscience’,118 and a synthetic approach promoting a dialogue between science and spirituality. Ferris introduces another dialogue, between contemporary and conventional literary genres, as he borrows from traditional genres like detective fiction, nineteenth-century poetry, and the Naturalist novel, so that he challenges both generic and historical categorization. This dialogical tendency is strengthened by intertextuality, as Dickinson’s poem structures his narrative, breaking textual barriers and generating another ‘dialogue among several writings’.119
While it is and is not a neuronovel, as Tim is and is not a patient, The Unnamed is certainly a ‘textual syndrome’, to quote LeClair, referring to the etymology of syndrome as ‘a place where several roads meet’.120 It is also an ‘open work’, in the sense of Umberto Eco, that readers are invited to interpret and ‘conclude’,121 and a ‘literary laboratory’,122 that is, a site for experiments and investigation, particularly of the relations between brains, minds, bodies, and world.
Works Cited
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Dickinson, Emily, ‘After great pain, a formal feeling comes—’, in The Complete Poems (Global Grey ebooks: 2020), p. 357.
Eco, Umberto, The Open Work, trans. by Anna Cancogni (Cambridge: Harvard University Press, 1989).
Ferris, Joshua, The Unnamed (New York: Little, Brown & Co., 2010).
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Frank, Nathan D., ‘Of Non-Mice and Non-Men: Against Essentialism in Joshua Ferris’s The Unnamed’, Disability Studies Quarterly, 40.2 (2020).
Garland Thomson, Rosemarie, Extraordinary Bodies: Figuring Physical Disability in American Culture and Literature (New York: Columbia University Press, 2017).
Gendle, Mathew H., ‘The Problem of Dualism in Modern Western Medicine’, Mens Sana Monographs, 14.1 (Jan-Dec. 2016), 141–51, https://doi.org/10.4103/0973-1229.193074
Gerard Genette, Narrative Discourse: An Essay in Method, trans. by Jane E. Lewin (Oxford: Blackwell, 1980).
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Johnson, Gary, ‘Consciousness as Content: Neuronarratives and the Redemption of Fiction’, Mosaic, 41.1 (March 2008), 169–84.
Kalanithi, Paul, When Breath Becomes Air (New York: Random House, 2016).
Kristeva, Julia, Powers of Horror: An Essay on Abjection, trans. by Leon S. Roudiez (New York: Columbia University Press, 1982).
Kristeva, Julia, ‘Word, Dialogue, and Novel’, in Desire in Language: A Semiotic Approach to Literature and Art, ed. Leon by S. Roudiez, trans. by Thomas Gora et al. (New York: Columbia University Press, 1980), pp. 64–91.
LeClair, Tom, ‘The Unnamed’, review of The Unnamed, by Joshua Ferris, Barnes and Noble Review (18 January 2010), https://www.barnesandnoble.com/review/the-unnamed
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Norris, Frank, ‘The Mechanics of Fiction’ (December 1901) in The Literary Criticism of Frank Norris, ed. by Donald Pizer (Austin: University of Texas Press, 1964), pp. 58–61.
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Waugh, Patricia, ‘The Naturalistic Turn, the Syndrome, and the Rise of the Neo-Phenomenological Novel’, in Diseases and Disorders in Contemporary Fiction: The Syndrome Syndrome, ed. by T. J. Lustig and James Peacock (London: Routledge, 2018), pp. 17–34, https://doi.org/10.4324/9780203067314
1 Rebecca Solnit, Wanderlust: A History of Walking, 2nd ed. (New York: Penguin Books, 2001), p. 5.
2 Stuart Murray, ‘The Ambiguities of Inclusion. Disability in Contemporary Literature’, in The Cambridge Companion to Literature and Disability, ed. by Claire Barker and Stuart Murray (Cambridge: Cambridge University Press, 2018), p. 99, https://doi.org/10.1017/9781316104316.008.
3 Jason Tougaw, The Elusive Brain: Literary Experiments in the Age of Neuroscience (New Haven: Yale University Press, 2018), p. 3, pp. 74–92, https://doi.org/10.12987/yale/9780300221176.001.0001.
4 In the field of literature, ‘Neuro Lit Crit’, or cognitive literary studies, should be mentioned as well, with authors like Gabrielle Starr, Kay Young and Mary Thomas Crane, among others.
5 Tougaw, The Elusive Brain, p. 3.
6 T. J. Lustig, and James Peacock, ‘Introduction’, in Diseases and Disorders in Contemporary Fiction: The Syndrome Syndrome, ed. by T. J. Lustig, and James Peacock (London: Routledge, 2013), p. 1, https://doi.org/10.4324/9780203067314.
7 Tanja Reiffenrath, ‘Mind over Matter? Joshua Ferris’s The Unnamed as Counternarrative’, Literary Refractions, 5.1 (December 2014), p. 2, https://doi.org/10.15291/sic/1.5.lc.10.
8 Robert Aronowitz, ‘When Do Symptoms Become a Disease?’, Annals of Internal Medicine, 134.9 (Part 2), May 2001, 803, https://doi.org/10.7326/0003-4819-134-9_part_2-200105011-00002.
9 Annemarie Golstein Jutel, Putting a Name to it: Diagnosis in Contemporary Society (Baltimore: Johns Hopkins University, 2011), p. 4.
10 Ibid., p. 11.
11 Paul Kalanithi, When Breath Becomes Air (New York: Random House, 2016), p. 121.
12 Golstein Jutel, Putting a Name to it, p. 67.
13 Ibid., p. 64. Also see Arthur Frank, The Wounded Storyteller: Body, Illness and Ethics (Chicago: The University of Chicago Press, 1995), pp. 5–6.
14 A. Frank, The Wounded Storyteller, pp. 5–6.
15 Golstein Jutel, Putting a Name to it, p. 11.
16 Ibid., p. 84.
17 Joshua Ferris, The Unnamed (New York: Little, Brown & Co., 2010), p. 24.
18 Tougaw, The Elusive Brain, p. 4.
19 Reiffenrath, ‘Mind over Matter’, p. 4.
20 Nathan D. Frank, ‘Of Non-Mice and Non-Men: Against Essentialism in Joshua Ferris’s The Unnamed’, in Disability Studies Quarterly, 40. 2 (2020).
21 A. Frank, The Wounded Storyteller, p. 100.
22 Ferris, The Unnamed, p. 37.
23 The passage also suggests that it was a characteristic—or requirement—of Tim’s job that his mind and his intellect, should work intensely. Meanwhile, his body was forgotten. This interpretation establishes a connection between Tim’s job and his condition, but it is never clearly confirmed.
24 Ferris, The Unnamed, p. 37.
25 Ibid., p. 40.
26 Ibid., p. 42.
27 The same strategy is used on page 46: as Tim experiences his compulsive walking (‘some failsafe mechanism moved him around red lights and speeding cars’), two doctors are mentioned: ‘One located the disease in his mind, the other in his body’.
28 Goldstein Jutel, Putting a Name to it, p. 84.
29 Ferris, The Unnamed, p. 41.
30 Reiffenrath, ‘Mind over Matter’, p. 6.
31 Patricia Waugh, ‘The Naturalistic Turn, the Syndrome, and the Rise of the Neo-Phenomenological Novel’, in Diseases and Disorders in Contemporary Fiction: The Syndrome Syndrome, ed. by T. J. Lustig and James Peacock (London: Routledge, 2018), p. 18, https://doi.org/10.4324/9780203067314.
32 Ferris, The Unnamed, p. 38.
33 Ibid. p. 38, p. 46, p. 48.
34 Ibid. p. 39, p. 41.
35 The doctor is ironically named Klum, from the old German klumm (knapp), meaning short, limited.
36 Ferris, The Unnamed, p. 41.
37 Ibid., pp. 41–42.
38 Ibid., p. 64.
39 Ibid., p. 86 (emphasis added).
40 This is an allusion to a passage on page 65, where Dr Bagdasarian is talking to Tim: ‘“I know you’ve fallen into depression because no empirical evidence has emerged to exonerate you—I use your word, which I have remembered many years—to exonerate you from the charge of being mentally ill. You hate it when people say it is something all in your head.”’ (emphasis added).
41 N. Frank, ‘Of Non-Mice and Non-Men’.
42 For a detailed summary of these debates, see Nikolas Rose’s article, ‘Neuroscience and the Future for Mental Health’, Epidemiology and Psychiatric Sciences 25 (2016), 95–100, https://doi.org/10.1017/S2045796015000621.
43 Ferris, The Unnamed, pp. 100–1.
44 Ibid., p. 42.
45 Ibid., p. 65.
46 Frank Norris, ‘The Mechanics of Fiction’ (December 1901) in The Literary Criticism of Frank Norris, ed. by Donald Pizer (Austin: University of Texas Press, 1964), p. 59.
47 Ferris, The Unnamed, p. 119.
48 The four parts of the novel bear titles borrowed from the same poem by Dickinson: ‘The Feet, mechanical’, ‘The Hour of Lead’, ‘First—Chill—then Stupor’, and ‘then the letting go’. Dickinson describes how moments of intense suffering or grief are followed by periods of numbness, as the emotional trauma can hardly be processed. Ferris’s narrative follows the evolution of the poem, which thus structures the novel.
49 Norris, ‘The Mechanics of Fiction’, p. 60.
50 A. Frank, The Wounded Storyteller, p. 6.
51 Ferris, The Unnamed, p. 126.
52 Ibid., p. 24.
53 Ibid., p. 33.
54 Ibid., p. 44.
55 Ibid., p. 109.
56 See Marina Ludwigs, ‘Walking as a Metaphor for Narrativity’, in Studia Neophilologica. Special Issue ‘The Futures of the Present: New Directions in (American) Literature and Culture’, 87 (2015), 116–28, https://doi.org/10.1080/00393274.2014.981962.
57 Frank Norris, Vandover and the Brute, 2nd ed. (Lincoln: University of Nebraska Press, 1978), p. 309.
58 Ferris, The Unnamed, p. 252 (emphasis added).
59 Stephen J. Burn, ‘Mapping the Syndrome Novel’, in Diseases and Disorders in Contemporary Fiction: The Syndrome Syndrome, ed. by T. J. Lustig and James Peacock (London: Routledge, 2018), p. 45, https://doi.org/10.4324/9780203067314.
60 Ferris, The Unnamed, p. 214.
61 See Mathew H. Gendle, ‘The Problem of Dualism in Modern Western Medicine’, Mens Sana Monographs, 14.1 (Jan-Dec. 2016), 141–51, https://doi.org/10.4103/0973-1229.193074.
62 Julia Kristeva, Powers of Horror: An Essay on Abjection, trans. by Leon S. Roudiez (New York: Columbia University Press, 1982), p. 1, p. 2.
63 Ferris, The Unnamed, p. 109.
64 Ibid., p. 149.
65 Ibid., p. 195.
66 Ibid., p. 200.
67 Ibid., p. 207.
68 A. Frank, The Wounded Storyteller, p. 98.
69 Ibid., p. 103.
70 Ibid., p. 102.
71 Ibid., p. 98.
72 According to Gerard Genette, zero focalization ‘corresponds to what English-language criticism calls narrative with omniscient narrator […] (where the narrator knows more than the character, or more exactly, says more than any of the characters knows). In [internal focalization], Narrator = Character (the narrator says only what a given character knows) […]’. Gerard Genette, Narrative Discourse: An Essay in Method, trans. by Jane E. Lewin (Oxford: Blackwell, 1980), pp. 188–89.
73 Ferris, The Unnamed, p. 207.
74 Chingshun J. Sheu, ‘Forced Excursion: Walking as Disability in Joshua Ferris’s The Unnamed’, M/C Journal, 21.4 (2018), https://doi.org/10.5204/mcj.1403.
75 Ferris, The Unnamed, p. 221.
76 Ibid., pp. 222–25.
77 Ibid., p. 233.
78 Ibid., p. 222. Also p. 269, pp. 278–79.
79 A. Frank, The Wounded Storyteller, p. 6.
80 Tim ‘sp[eaks] a language only he underst[ands]’. Ferris, The Unnamed, p. 126.
81 Ibid., p. 310.
82 Sheu, ‘Forced Excursion’.
83 Reiffenrath, ‘Mind over Matter’, p. 14.
84 For a detailed analysis of the conflicting views of critics on The Unnamed, see Nathan Frank, ‘Of Non-Mice and Non-Men: Against Essentialism in Joshua Ferris’s The Unnamed’.
85 Joshua Ferris, ‘Involuntary Walking; the Joshua Ferris Interview’. ReadRollShow. Created by David Weich. Sheepscot Creative, 2010. Vimeo, 9 Mar. 2010, https://vimeo.com/10026925.
86 See Tougaw, The Elusive Brain, pp. 132–35.
87 Ferris, The Unnamed, p. 247.
88 Ibid., p. 208 (emphasis added).
89 Ibid.
90 Ibid., p. 25.
91 See Leo Marx, The Machine in the Garden. Technology and the Pastoral Ideal, 2nd ed. (Oxford: Oxford University Press, 2000).
92 Ferris, The Unnamed, p. 143.
93 Ibid., p. 148.
94 See Peter Ferry, ‘Reading Manhattan, Reading American Masculinity. Reintroducing the Flâneur with E. B. White’s Here Is New York and Joshua Ferris’s The Unnamed’, Culture, Society & Masculinities, 3.1 (2011), 49–61 (p. 50), https://doi.org/10.3149/CSM.0301.49.
95 Ferris, ‘Involuntary Walking; the Joshua Ferris Interview’.
96 David Serlin, ‘Disabling the Flâneur’, Journal of Visual Culture, 5.2 (2006), p. 200, https://doi.org/10.1177/1470412906066905.
97 Ferry, ‘Reading Manhattan, Reading American Masculinity’, p. 50.
98 Rosemarie Garland Thomson, Extraordinary Bodies: Figuring Physical Disability in American Culture and Literature (New York: Columbia University Press, 2017), pp. 8–9.
99 Murray, ‘The Ambiguities of Inclusion: Disability in Contemporary Literature’, p. 96.
100 Ferris, The Unnamed, pp. 104–5.
101 Garland Thomson, Extraordinary Bodies, p. 8.
102 Sheu, ‘Forced Excursion’.
103 Ferris, The Unnamed, pp. 278–80.
104 Ferris, The Unnamed, p. 65.
105 Disability is also questioned in another neuronovel, Motherless Brooklyn. The protagonist’s Tourette’s turns into a benefit and not a blemish. See Pascale Antolin ‘“I am a freak of nature”: Tourette’s and the Grotesque in Jonathan Lethem’s Motherless Brooklyn’, Transatlantica 1, 2019, https://doi.org/10.4000/transatlantica.13941.
106 Tom LeClair, ‘The Unnamed’, Review of The Unnamed, by Joshua Ferris. Barnes and Noble Review, 18 January 2010, https://www.barnesandnoble.com/review/the-unnamed. Wider than the Sky. The Phenomenal Gift of Consciousness is also the title of an essay by neurologist Gerard Edelman (New Haven: Yale University Press, 2004).
107 Ferris, The Unnamed, p. 44.
108 Ibid., p. 233.
109 Tougaw, The Elusive Brain, p. 12.
110 Ferris, The Unnamed, p. 304.
111 Burn, ‘Mapping the Syndrome Novel’, p. 46.
112 Ferris, The Unnamed, p. 252.
113 Ibid., p. 300.
114 Ibid., p. 304.
115 Burn, ‘Mapping the Syndrome Novel’, p. 46.
116 Ibid., p. 47.
117 N. Frank, ‘Of Non-Mice and Non-Men’.
118 Burn, ‘Mapping the Syndrome Novel’, p. 47.
119 Julia Kristeva, ‘Word, Dialogue, and Novel’, in Desire in Language: A Semiotic Approach to Literature and Art, ed. by Leon S. Roudiez, trans. by Thomas Gora et al. (New York: Columbia University Press, 1980), p. 65.
120 Online Etymology Dictionary, https://www.etymonline.com/word/syndrome.
121 Umberto Eco, The Open Work, trans. by Anna Cancogni (Cambridge: Harvard University Press, 1989), p. 19.
122 Tougaw, The Elusive Brain, p. 5. Tougaw borrows the image from Heather Houser’s Ecosickness in Contemporary U.S. Fiction: Environment and Affect (New York, Columbia University Press, 2014).