Book Review

The essay collection Field Guide to Falling Ill, the first winner of the inaugural Yale Nonfiction Book Prize, opened with an excerpt from the poem “Charlie Howard’s Descent” by Mark Doty. Charlie Howard was a twenty-three-year-old openly gay man who lived in Maine during the 1980s, three teens threw him into a river and left him to drown. This hate crime, and its memorial poem, are tragic, though one may not know it from the excerpt that author Jonathan Gleason picked:

he is beautiful

and like any good diver

has only an edge of fear

he transforms into grace.

That Gleason excerpted this part was a surprise to me, at first. Here, the poet finds beauty in a life so short, one lived bravely despite consequence. The courage to keep on, in spite of the cards dealt, serves as a recurring theme throughout Gleason’s essays of “the human lives behind the practices that shape disease.”

Perhaps he picked it in light of his own life. Jonathan Gleason, as both an individual and professional, is fit to tell these tales. He was both a former medical student and then medical interpreter, and like the rest of us, a hospital patient and human being. His stories often include his lived experience as a farm hand, an employee, a gay man, a nephew, a son, a roommate, and a friend.

The first essay in his collection, “Inheritance,” concerns Gleason’s two cousins who were both born with Tay-Sachs disease, a rare lethal genetic disorder which breaks down fat in the brain, causing nerve damage, then seizures and death. Gleason as a child feels a “piercing sense of tragedy.” His baby cousins were not supposed to die. He writes clearly, with no frills: “There were no preexisting conditions, no history of severe neurological disease, no visible explanation” about why these children were getting sick. A young Gleason, taking chemistry and biology at the university while a high school student, narrates that, at the time, he “still thought the world could be explained in terms of medicine alone.” Now as an adult, Gleason’s book does this work of chipping away at his childhood belief, taking the reader through a perspective retrospective. With each essay, Gleason writes towards a more complicated and truer present.

These essays, though quite personal, resist self-indulgence: He puts the stories and diseases within their historical context. Gleason discusses Tay-Sachs disease being first linked to Jewish immigrants in a way that echoed the COVID pandemic’s onslaught of anti-Asian violence, about the backlash of AIDS during the 1980s and its ripples into the present day, the inherent struggles of being a medical interpreter for perfect strangers who may or may not trust you with their lives, of healing from PTSD after a shooting, and how the opioid epidemic affects those closest to us. The personal is, indeed, political.

I appreciate that Gleason wrote about medicine this way. He’s not frilly, necessarily, nor is he sterile. I expected statistics and figures, which he does include, but they take a backseat to the human side of medicine—in our search to cure, heal, and persevere—despite it all. I found myself thinking that Gleason’s “falling ill” is a constant state of being here. Inherently shaped by culture, money, age, race, gender identity, and sexuality, being sick is not as simple as a diagnosis.

The last essay, “No Harm,” read to me as a direct contrast to Gleason’s first essay, returning to the young Gleason’s conviction that medicine alone can explain the world, and proving it false. Dr. Husel was like any other night doctor at Mount Carmel Hospital in Columbus, Ohio, barring his habit of prescribing way too many painkillers to his end-of-life patients. This essay is where Gleason’s themes collide—Dr. Husel served a neighborhood in Columbus known for its “high rates of poverty, alcohol, and drug addiction,” raising the question of whether this delinquency may have been questioned sooner in a wealthier neighborhood. However, there are nuances on the doctor’s side, as well—if these patients were already suffering and facing end-of-life care, wouldn’t it be generous to end their pain? Is Dr. Husel an “angel of death” or murderer? Medicine inherently has a human touch, whether that’s positive or negative. Dr. Husel, and all practitioners of medicine and service, are privy to that. Gleason and his readers see that medicine is not as simple as right or wrong, black or white.

Ironically, I’m writing this review while I myself am sick, with a gnarly sinus infection that has more than overstayed its welcome. I don’t particularly like missing work, wasting tissues, or being reminded of my mortality. Gleason’s book was illuminating in its reminder that illness is part of being human, in all of its complexities. While yes, Field Guide to Falling Ill is about disease, it is also a field guide to the lived experiences that Gleason and I, and all of us, share.