The Illness Lesson: Strange symptoms – and treatments

The Illness Lesson

Author: Claire Beams

ISBN-13: 9780385544665

Publisher: Doubleday

Guideline Price: £12.99

The colonisation of the female body by centuries of male medics has been the subject of some excellent non-fiction in recent years. Leslie Jamison’s The Empathy Exams was a stylish manifesto on “all the ways a woman can hurt”. Invisible Women by Caroline Criado Perez used data to show how gender blindness in medical trials is harmful for women.

On the home front, Sinéad Gleeson’s award-winning collection of essays Constellations gave, among other topics, a startling account of the indignities endured by female patients at the hands of male doctors. Women writing about the body is not a new tradition – think of Virginia Woolf, Susan Sontag, Nuala O’Faoláin, Anne Enright – but in this MeToo era there is a notably wider interest and readership.

The female body has also been central to some remarkable debut fiction in the last few years: Sue Rainsford’s Follow Me to Ground, Alexandra Kleeman’s You Too Can Have a Body Like Mine, Saskia Vogel’s Permission, to name a few. Joining the fray is The Illness Lesson by Clare Beams, a debut novel set in late 19th century Massachusetts.

The past is a clever place from which to discuss modern preoccupations around ownership, identity and the body. Narrator Caroline is part of a small team of teachers who establish a progressive boarding school for young women. The School of the Trilling Hearts, so named for a rare (and fictional) flock of birds found on the grounds, is set up by Caroline’s father, a widower who has devoted his life to advancing liberal education. An intellectual who was once famed for his policies, Samuel’s star faded after a failed attempt at a boys’ school and the subsequent publication of a novel written by a peer, Miles Pearson, that villainised old Sam while making his wife – Caroline’s dead mother – out to be both a beauty and a tramp.

Fits and faintings

In the present-day narrative, a handful of young women choose to attend the elite boarding school. Initially well drawn and vibrant, most of these characters sadly fade to obscurity, which is a particular shame given the subject matter of the book. The problem is one of overloading – Caroline’s mother’s back story, and the mystery of her death, is given too much prominence.

Far more interesting are the circumstances at the school. The first few months proceed as planned: the girls read Shakespeare, learn Latin, are tutored in philosophical thinking. Joining Caroline and Samuel is devotee David, and latterly another female character, Sophia, a surprising and nuanced portrayal of a woman of that era. The last of the central characters is one of the students, Eliza, the daughter of Miles Pearson who has come, we suspect, to make trouble rather than to learn.

The plot hinges on strange happenings at the school, a storyline that is thought-provoking and suspenseful. One by one, the girls get sick, their bodies seemingly in tune with each other as fits, rashes, faintings take place: “After Meg, it happened quickly. Rebecca collapsed in the garden. When she came in to report this there was a streak of dirt across her cheek. Felicity lowered her collar to show her red pocked neck. Julia shifted her skirts to show a rope burn of red circling her ankles.”

Hysteria

For all his progressive talk, Samuel calls in an old-school physician, the creepy Hawkins who deduces, after little to no investigation, that the girls are suffering from that well-known, catch-all disease of “menstrual hysteria”. Beams is excellent on the power and ignorance of the 19th century medic: “His eyes were so full of what he expected to see that he wouldn’t really look at them.” Elsewhere we learn, “While the literature of hysteria dates back thousands of years, few modern physicians would argue that the disease is caused by an actual wandering of the womb. Instead, the modern view is that the symptoms stem from a pelvic congestion.” But what we really learn through a series of engaging scenes is that no one has a clue, and that the treatment prescribed by Hawkins is invasive, absurd and would be considered criminal today.

Beams’ depiction of the treatment of women at the hands of men – even supposedly enlightened men – recalls The Fever by Megan Abbott. There are echoes of Arthur Miller’s The Crucible, too. Beams keeps us guessing as to the girls’ culpability, though a rushed ending sweeps them off stage, choosing instead to focus on Caroline’s story.

The author lives in Pittsburgh, where she teaches creative writing, most recently at Carnegie Mellon University. Her short story collection We Show What We Have Learned won the Kirkus US Best Debut in 2016. It was praised for its feminist insights, something which can also be said of her debut novel. The Illness Lesson is a colourful, memorable story about women’s minds and bodies, and the time-honoured tradition of doubting both.