Book Review: How does it hurt? by Stephanie de Montalk

Available in bookstores nationwide.

A review should, as a rule, be an impersonal thing. But occasionally a book falls into your hands that resounds with you in such a tortuously familiar way that it’s impossible not to feel your own related experiences playing in the background as your read. With that in mind, this is a review of Stephanie de Montalk’s How Does It Hurt?, my reading of which was underpinned by my own experiences with chronic pain and illness and the medical world.

How does it hurt? is both informative and intimate, with her research into chronic pain constantly underscored by her own experiences as both nurse and patient. It is at times terrifying, other times upsetting. But it is also both entirely engrossing and beautifully written.

In the first section ‘The Shirt of Nessos: An essay on the experience of writing about pain’, de Montalk mentions the idea that the English language and literary canon fails us when we try to talk about pain, specifically referring to Virginia Woolf’s words on the subject. There is definitely truth in de Montalk’s observations, but she herself proves very capable at recreating in a very visceral manner, time and time again, the sensation of being in constant chronic pain.

‘[The] pain had escalated beyond any level at which I had known it before. It dragged: a cat at the curtains. It burned: a smokeless flame, a coal smouldering. It drilled. It needled like crushed glass.’

For anyone who has also experienced this kind of pain, these descriptions feel all too prickly and familiar. As she goes on to say later, “[severe chronic pain] waits in the mind as if haunting the wood of an instrument long played, storing and orchestrating sounds for the future.’ De Montalk is known as a biographer and a poet – How Does It Hurt? turns the biographical eye in on herself, and her poetic voice shines through in the prose as well as the poetry snippets that are scattered throughout the book.

A bit over half of the book is memoir; the second half is a complementary collection of creative explorations on the lives of other writers who have focused on pain and of de Montalk’s own poetry. The memoir section takes us through her earliest days of medical recollection, to her nursing training, and most significantly, the ongoing saga of her experience with pain.

As well as a journey through time and through health lows and highs, the memoir takes us across the globe. The ill-administered anaesthetic during a C-section in 1970’s Hong Kong may be hard to beat in terms of squeamish horror, but the constant rumblings of pelvic nerve pain are equally unsettling in their own way: a contrast altogether appropriate for a book that describes the differences between acute and chronic pain. De Montalk describes the hopeful medical developments taking place through research happening in Sydney and Nantes; and Poland as a place both of family history and of grievous injury. Book-ending all of this, New Zealand is placed as both the beginning of the story and the present-day end.

The book is serious in content, but that doesn’t mean it’s constantly bogged down with a serious tone. References and quotes flit from Nietzsche to Cole Porter to Frida Kahlo. The ‘interviews’ and pieces on other writers (namely Alphonse Daudet (aka ‘The Vendor of Happiness’), Harriet Martineau and Aleksaner Wat provide different kinds of voices – keeping things fresh while not deviating from the overarching intent. And an ongoing story of trees – conifer, pine, macrocarpa – provides parallels with de Montalk’s own experiences, with the epilogue concluding, ‘It’s strange…the way it still dominates the landscape from our place, but from here it seems unremarkable.’

In How Does It Hurt?, I found a voice I recognised, and one that many others will also be able to relate to. For some, it will be reassuring, in a way, to see experiences not dissimilar from their own on paper. For others, it will be an eye-opening read – describing sensations and circumstances hitherto unknown.

Regardless of your own experiences with chronic pain, How Does It Hurt? is an important and beautiful book, both tragic and hopeful.

Reviewed by Briar Lawry, bookseller at Unity Books, Wellington and freelance writer

How does it hurt? 
by Stephanie de Montalk
Published by Victoria University Press
ISBN 9780864739698