The Prose for the Healthy

The dynamic of sanatorium literature is often described with Michel Foucault’s concept of heterotopia. The French philosopher considered prisons, recreational centres, cemeteries, and psychiatric hospitals to be non-places, spaces organised in a way that would undermine the order of places considered “natural” while serving as sites of exclusion for those who failed to fit the universally accepted norm.

In 1943, the year streptomycin was invented, the chances of survival for tuberculosis patients changed dramatically, as had the rhythms of sanatorium literature. The new-found cure for this previously terminal disease that was causing 25 per cent of all deaths in 19th-century Europe made it relatively easy to cure. Sanatorium prose whose crown jewel, Thomas Mann’s “The Magic Mountain”, published only two decades before Salman Waksman and his team discovered the life-saving antibiotic, soon lost its sharp edge, its dark core.

Mann designed his most famous novel to be a satire on the insular world of tuberculosis patients, mocking the starkly selective reality in which wealthy patients spend their time lounging on terraces, indulging in fundamental yet pointless disputes. While the parodic aspect of the novel has become illegible for modern readers, Mann managed to establish a blueprint for depicting the sanatorium environment for the authors to come.

Mann’s parodistic impulse led to presenting tuberculosis patients in “The Magic Mountain” as if through a glass wall. Their illness aligns with all other issues: literary, ontological, epistemological, and ideological alike. The lounge deck blanket wraps them all alike. On the other hand, Max Blecher – a Romanian author with Jewish roots – whose novel “Scarred Hearts” is just a few years younger than Mann’s, approached the subject in a completely different way. Blecher was one of the most fragile modernist literature icons – diagnosed at the age of 19, he’d spent a decade treatment for bone tuberculosis, and wrote only three novels in his life, gaining literary fame posthumously. Everything that healthy Mann failed to fit into his frame of representation, ailing Blecher included with all the physiological and cognitive consequences. Tormented by pain, physical limitations, and acute awareness of death, Blecher spent his entire adult life writing with blood –most literally. Emanuel, the novel’s main character, arrives at the Beck-sur-Mer sanatorium in the north of France right after receiving the diagnosis and having lymph drained from an alarmingly fast-growing tumour. Locked in a plaster corset, he becomes a human object, an uncanny hybrid capable of grabbing objects but not of walking, lifted and carried to bed by troops of nurses. The world created by Blecher turns an even more perverse hue once we realise the writer portrayed his peers: young people with intense sex drive, sensual, struggling with sexual barriers they were double fenced behind by puritan bourgeoisie mentality on the one side, and the sanatorium rules on the other. Blecher’s descriptions of sex break out a chasm in the high modernist prose, in the narratives of Davos (Mann) and Balbec (“In the Shadow of Young Girls in Flower”, Marcel Proust’s second volume of “In Search of Lost Time”), also because in his novel, the Romanian writer introduced female characters. According to the sanatorium prose researchers, most authors would establish the narrative from the perspective of a young man, usually with technical education. Indeed, Mann’s Hans Castorp is a future naval engineer and Blecher’s Emanuel a chemistry student.

The dynamic of sanatorium literature is often described with Michel Foucault’s concept of heterotopia. The French philosopher considered prisons, recreational centres, cemeteries, and psychiatric hospitals to be non-places, spaces organised in a way that would undermine the order of places considered “natural” while serving as sites of exclusion for those who failed to fit the universally accepted norm. Barbara Klicka and Olga Tokarczuk bounce off such heterotopic images in their contemporary novels “Zdrój” and “Empuzjon”, twisting the rules of the genre established by the writers of high modernism – not only because of the invention of streptomycin but also due to a different cultural code in which both Polish writers operate. In “Zdrój”, Klicka tells the story from the perspective of thirty-year-old Kama who must go to a sanatorium after oncological treatment in order not to lose access to healthcare. It is her first visit to such a place as an adult; she did, however, spend most of her childhood in various health resorts. She remembers all the defence strategies she had developed and is well aware of the threats that await her in a place like this. In “Zdrój”, most of the sanatorium residents don’t think much about recovery; they are more into having fun and taking some time off from their everyday lives. This is not to say the sanatorium is any less violent than the world outside – Kama experienced abuse as a child, and having been exposed to violence, she can predict it. Knowledge, however, is not power, quite the opposite – the awareness of who and how can hurt her makes Kama more agreeable, compliant, flexible, and ready to compromise.

The medical staff in literature change their roles with the times and the characters’ gender. In Blecher’s novel, the doctor serves as an intermediary between the outside world of “norm” and the heterotopia of a sanatorium; he symbolises the opposition between health and illness, between theoretical medical knowledge and the very practical experience of ailment. His words have the power to heal or kill the patients as they either give hope or take it away. The lower-ranking staff, however, remains absent: the orderly who gives Emanuel his daily wash behind locked doors – to keep the humiliating ritual hidden from any prying eyes – remains nameless, as are the nurses pushing patients’ wheelchairs and accompanying the young man in his travels. Blecher forgot the subjective nature of this service to such an extent that he would describe the patient’s transport as an independent activity: Emanuel, stretched on a board and immobilised in a cast corset is often said to “go” or “walk” somewhere, even though the reader is perfectly aware of him being pushed or carried there.

In this aspect, neither Klicka nor Tokarczuk seems to be quite “democratic”. In “Zdrój”, there is little difference between a female doctor and a male physiotherapist: everyone commits various acts of violence against Kama, and everyone uses her to build their own position. One of the symbolic signs of belittlement and humiliation Kamila experiences is the condescending tone the staff uses when speaking to her. She cannot request a pass or complain about painful procedures. Medical examination revolves around testing her endurance and pulling at her scar, that is – aiming at her weakness, bringing to light what’s most painful, most carefully guarded. Physiotherapist Mariusz reduces Kama to a convenient, easily available body, and attractive at that: she’s one of the few young and attractive women in the sea of old ladies. Kama yields to “Mr Mariuszek”, accepting one transgression after the next: first a coffee date, then using first names, touching, sexual innuendos (‘Oh, Kamilka, did you know I can unfasten a bra with one hand? He asks, unfastening my bra with one hand. Can your husband do that?’). Violence is one common denominator for all levels of medical personnel, whether we follow the experiences of Kama as an adult or as a little child, served another ladleful of milk soup by her sadistic carer for every half an hour of dawdling over her plate.

In “Empuzjon:, the owner of the Gentlemens’ Guesthouse, along with the servant at his employment, both defend the patriarchal order, looking for weak victims to appease Tuntschi – forest creatures with bodies of “provisional texture”. Another character, the head doctor at the sanatorium, first mocks the main character for their shyness only to eventually become their main benefactor and an architect of the new order.

In his book “Czytać, dużo czytać” (Read, read a lot), Ryszard Koziołek included an essay on “Empuzjon”, in which he claimed that the two main reference points for the novel are the writings of Plato and Thomas Mann. This is certainly true if we consider the most important subplot of the novel to be the conflict between patriarchy and femininity. However, it seems that the relationship between two patients in Blecher’s “Scarred Hearts” is just as meaningful a reference point. After his arrival in Berck-sur-Mer, Emanuel starts an affair with Solange, a perfectly healthy woman who is as beautiful as she is pedestrian. He loves her and he hates her, smelling his own poorly washed body while kissing her skin; he admires her slim figure while being forced into a horizontal position.

At some point, Emanuel starts a new relationship with another patient, Isa, who is as ill as he is. It is Isa (or, rather, her maid) who gives him Comte de Lautréamont’s Les Chants de Maldoror. Blecher even included a quote from de Lautréamont, describing a hermaphroditic character: There in a flowery grove the hermaphrodite sleeps a deep heavy sleep, drenched in his tears. The birds, waking, contemplate, enraptured, this melancholy figure, through the branches of the trees, and the nightingale will not sing its crystal-toned cavatinas. The presence of the unhappy hermaphrodite has made the wood as august as a tomb*. Emanuel is deeply affected by the sensuality of this text, its frenetic and melancholic nature. What sends him back to Tokarczuk, however, is not the melancholy itself, but the silence of the forest – nature that coaxes, stands by the side of the grief-stricken character. This very scene lends a key to the plot twist in Empuzjon in which men organise a hunt for someone they could sacrifice to Tuntschi and tie Mieczysław Wojnicz to a tree. The vulturous creatures, however, don’t eat Wojnicz as he fails to meet the basic conditions of masculinity:

“Our gaze penetrates him deeper. We can see his bones, the beating heart, the ever-twisting gut, the oesophagus that keeps on clenching … His diaphragm goes up and down, and droplets of urine drip from the kidneys to the bladder. The womb clamps close like a fist while the member swells with blood.”

Wojnicz (incidentally, a polytechnic student) arrives at Görbersdorf as a tuberculosis patient but we soon discover he ended up there because of the shame his father felt about him – it is, in fact, more of an exile than a retreat. Wojnicz’s enlarged nipples, poor health and feminine fragility make numerous medical consultations and trips to see doctors in Lviv and Cracow hopeless – this “case” has no cure. The main issue this character suffers is not tuberculosis but being non-binary. And just like in “Zdrój”, the memories of harm Wojnicz suffered in childhood intertwine with the violence doled out by the sanatorium personnel. He knows the drill inside out: name, patient card, medical record, undressing behind a screen, then examination couch. He hates undressing and refuses to take his clothes off for examination and during treatment. Calm, withdrawn, “slow” (or, rather, broken by his father), Wojnicz resists only once: when the attending physician mocks his modesty and deems him an “Eastern savage” who, led by superstitions, refuses to undergo a modern medical procedure that is being examined while fully naked. And yet, upon finally getting his way, the doctor takes his patient’s side, even more than that: he becomes Wojnicz’s guide, teacher, and mentor. Wojnicz rejects his transsexuality and hates this “trait”; those times when he sneaks into the room where feminine clothing is stored are, in his eyes, proof of terrible weakness. Tokarczuk presents his story with unconcealed didacticism, having the sanatorium doctor deliver a speech in defence of transsexuality: “This is the body’s cosmos. Anything can be an anomaly that might soon turn into an advantage that helps one win the evolutionary race. It is only a matter of how we see it.”

It would be hard to write about the “black melancholy” today. Crises usually have their roots elsewhere, and prose is expected to diagnose very different problems. While the connections between youth and illness, isolation and belonging, or the modernity of the hospital and corporeality of death in coughing spasms were important themes for early 20th-century writers, today, they can only be simulated – and even then, they will never be as dramatically charged as they were a century ago. For this reason, contemporary literature uses sanatoriums only as backdrops for completely separate issues to be resolved. Tokarczuk, while seemingly faithful to the 1920 and 1930s sanatorium prose (even in the concealed references planted throughout the book), uses this genre for her purposes to draw an allegoric tale of patriarchy’s fears and of the niches in which men still tend to their dreams of grandeur. Klicka’s approach is very different: to her, the sanatorium is a space of women’s violence against other women, of taking on the roles of male dominators or mimicking their behaviours and enjoying the acts of humiliating girls and young women – weak and failing to fit into the patriarchal model. This happens when women gang up on Kama: a group of old women gropes her in the showers inquiring why she doesn’t want to have a child. Her body is perceived only through the lens of its biological usefulness: the woman’s fate is to bring forth children (in pain).

Both authors maintain two major oppositions: sanatorium versus the outside world and the ill versus the healthy. Unlike the early 20th-century writers, however, they deepen the conflict between the main characters and their environment: in their worlds, there is no hope for finding allies, intellectual friendships, or mentors. Violence – verbal, suffocating, cornering – experienced from their surroundings is an everyday reality for both characters, doomed to their life in sanatoriums. Both Kama and Wojnicz are being misled and used for building the ‘community’: in “Zdrój”, the group effort is applied to persuade Kama into believing she is pregnant, while in “Empuzjon”, the host serves his guests “Angstel” – rabbit heart goulash – and after the meal, he describes the brutal way of killing the animals which, supposedly, contributes to the rich flavour of the dish.

By setting her novel in the year 1913 in Sokołowsko – the first spa resort in Poland (as of its contemporary borders) – Tokarczuk picks up the tradition of high modernism. Klicka refers to a completely different structure: she finds herself closer to the communist-working class model of sanatorium trips as prescribed by doctors or financed by the factory social fund as part of the workers’ holidays. The socialist-style rooms, faux leather, milk soup, lack of coffee, and even the group trips on free Sundays – Klicka takes all those props from the recent past to furnish her novel. While Tokarczuk roams her pretend-Davos, Klicka chooses to play in Ciechocinek. Still, both writers, regardless of the class traditions they choose as backdrops for their novels, tell stories of extreme violence: it’s probably the most significant difference between the high modernism in its masculine form and the late “feminine” postmodernism.

Wojnicz believes that his father loves him, even though he remembers him as strict, unforgiving, never willing to understand and always ready to break his child in. Meanwhile, Kama wonders why, once again, she found herself in a place just as oppressive as the institution she was put through as a child. She doesn’t look for ways of escaping the sanatorium as she well knows the system leaves no space for such endeavours, and that she’s there to put up with everything and anything. In contemporary prose, sanatorium – despite its declarative roles – turns into hell. Instead of treating patients, it humiliates them, gnaws away at their mental health, and questions their cognitive abilities along with knowledge of who they are and how well they can remember their own past.

Translated from the English by Aga Zano