Book Review: Tender Points (Amy Berkowitz)Reviewed by Loretta McCormickEarly on in Amy Berkowitz's lyric essay, Tender Points, she writes "I don't like riddles. And yet here I am, obsessed with solving a riddle of my own, the riddle of my body: Why, exactly, am I constantly in pain?" The simple, straightforward answer is that Berkowitz has fibromyalgia – a chronic illness, mostly affecting women, with symptoms that include chronic muscle and joint pain, sleep problems, fatigue, and memory challenges. However, the real riddle couched in her question is an enigma which explores the gendered and ableist constructs that shape her lived experiences with chronic illness. When Berkowitz asks, "Why, exactly, am I constantly in pain?" it is the weight of the word "exactly" that pushes her readers toward answers. The title of her book alludes to the most common method of diagnosis, a test of this constant pain in which doctors apply pressure to specific "Tender Points" of the body. Berkowitz explains, "In order to be diagnosed, the patient must experience discomfort in at least 11 of 18 Tender Points designated by the American College of Rheumatology." But within the gendered paradigm of diagnosis and treatment, the accuracy of a test is ultimately determined not by the answers a patient gives, but by exactly how much a doctor believes in his patient's pain. For many doctors fibromyalgia, like hysteria before it, has become a catch-all diagnosis of women's overactive imaginations, or overstimulated minds. Berkowitz points out, "Today, doctors' insistence on the mysterious, unknowable nature of fibromyalgia functions as a similarly misogynistic tactic, trapping female patients in a state of uncertainty where it's impossible to assert themselves or be heard as an authority on their own experience" (88). Tender Points, then, is an important affirmation of women's authority over their own bodies. The very structure of the book resists the implication that fibromyalgia is a weakness or frailty. In a voice that is angry, frustrated, and slightly taunting toward those who would deny the reality of her illness Berkowitz writes, "I'm writing about the violence of patriarchal culture. I'm writing about the uneven balance of power in female-patient/male-doctor relationships. I'm aware of a certain home-team advantage, and I will not dare write this in anything that can't pass for straight masculine prose. It's not that this isn't écriture feminine , but it's écriture feminine en homme." She writes concise fragments of her life, sometimes in the form of "listicles, or articles in the form of lists" – "6 Essential Items for Your Post-Traumatic Stress Disorder Cave," and "4 Events You Miss Because of Fibromyalgia Pain" – because, "The content is easy to digest and the authoritative headlines command respect." By attempting to nullify the myth of women's writing as innately florid or diffusive, Berkowitz is forcing an examination of the way masculine prose, assumed to be strong and direct, works to silence women in many areas of their lives. Throughout the book, she also inserts a wide variety of pop culture references, again written in discreet, terse fragments. The references range from a description of a meeting between Kathy Acker and Kathleen Hanna of Bikini Kill to musings on Krang, the disabled villain in Teenage Mutant Ninja Turtles. Ann Carson, Sex and the City, Susan Sontag, America's Funniest Home Videos, noise music, Twin Peaks, and an exhibition of Mike Kelley's work are all "POINTS TO REMEMBER" that are honed as sharp as lances in self-defense and resistance against the systemic misogyny she navigates in living with her chronic illness. All these non-linear nodes of pop culture musings and the sharp fragments of a narrative puzzle begin to arrange themselves into a discernable pattern as she deciphers the most important pieces of her "riddle." Berkowitz starts to puzzle together the memory of her rape at the hands of a doctor when she was a child. And, although she writes the trauma of her rape in the same spare, tight prose, the memories themselves are not as sharp and clear as the other points she remembers. She reveals:
I have fragments. I remember it was cold. I remember It is not simply that the trauma of rape at the hands of her doctor has forced her to protect herself by blocking some memories. She underscores that rape culture doesn't just give a doctor the power to rape a young girl in his office, it engenders a woman's doubt and guilt over the violation she endured, even many years later:
I asked myself if I was lying However, Berkowitz does do something not merely important, but necessary, in writing this text. Nowhere is the importance of her work more conspicuous than towards the end of the book, when she details moments with new and old friends in which rape is always an unavoidable topic. The fact that it is so ubiquitous angers her as she imagines the many conversations as a series of paintings, "All with the similar theme of Brilliant Women Talking About Rape Again (Instead of Talking About Their Art or Any Other Topic)". But they are talking, exposing the crimes against them, even if only to each other. Ultimately, we don't get an answer to the riddle of why she is constantly in pain, at least not one that is entirely satisfying. For a satisfying answer would entail closure, which the persistence of misogyny within the medical field and every other aspect of our lives does not allow. However, when we read this text, we can assert our belief in the real, debilitating pain of chronic illness and trauma many women must manage and recognize the authority and agency all women must have over their bodies.
Title: Tender Points
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