IN THE TITULAR ESSAY in Dodie Bellamy’s new collection When the Sick Rule the World, Bellamy prepares to go to a meeting for the environmentally ill. She buys the necessary fragrance-free soaps and shampoos, forgoes deodorant, and readies herself for “entry into the realm of the sick.” She makes a mistake, however, in applying some “locally made, stone-crushed extra virgin oil” to her hair, and the gatekeepers sniff her out immediately. One of the women at the door accuses Bellamy of giving her “brain fog.” Bellamy is forced to wear two bandanas around her head, one black and one green, to cover the offensive smell. She finds the getup so ridiculous that she can barely look at herself in the mirror.

The demands of sick bodies rapidly accumulate. One woman hangs aluminum mesh curtains around her bed to protect herself from the electromagnetic waves emitted by cell phone towers. For travel, sick men and women require “trailers made from steel and non-fragrant wood.” The sick also need kitchens, showers, and bathrooms even when they can’t tolerate sleeping indoors. Bellamy’s essay explores what very few such accounts have explicitly acknowledged — how demanding the sick and the sensitive are of “the well.” One of the costs of sickness is monetary, of course (as we well know in this insurance-confused country). Bellamy herself can’t help but mention the $30 she spends on fragrance-free products. But sickness also has other, nonmonetary costs. How many inconveniences, however slight, are “the well” ready to accept? How many aesthetic atrocities, how many hideous bandanas? We don’t always resent these sorts of accommodations, but often, we do.

The demanding body, in all of its annoyances and inconveniences — its disruptive potential to the smooth flow of lives and capital, all its “irrational” wants and desires — is central to Bellamy’s new book. Sometimes that demanding body is her own, since Bellamy doesn’t shy away from writing about herself, but more importantly it often belongs to another — the sick, the dying, the homeless. Many of these essays are part memoir, part theory, while some are just imaginative riffs on a subject. Overall, When the Sick Rule the World is characterized by the same versatility that has been a hallmark of Bellamy’s long career, which has included works of poetry, memoir, fiction, essays, criticism, and almost everything in between.

The varied projects of that career are difficult to summarize quickly. Bellamy’s name is closely linked with the New Narrative movement in San Francisco. She is known for appropriating William Burroughs’s “cut-up” technique in the making of CuntUps (2001) and Cunt Norton (2013), in which she engaged in systematic destruction of the patriarchal voices in the canon. In 2014, she published The TV Sutras, an examination of media and religious experience, which combined poetry, essay, and her own experience in a New Age cult. An essay in an earlier collection, Academonia (2006), is dedicated to a discussion of her theories on genre, as well as the institutional discomfort with writers who straddle generic divides. New Narrative, for example, “threatens the line between theory, fiction, and autobiography. This confusion is reduced in some English Departments by simply calling it poetry.” This anxiety “comes out of a panic over identity and ambiguity,” Bellamy theorizes. “Before the abjection of a blurred genre the traditionalist feels faint. As when death infects life, when poetry infects fiction, identity, system, order is disturbed.”

The sick, the abject, the old — bodies infected with death, to use Bellamy’s own terminology — are perhaps the logical subject of this hybrid form. Our discomfort with blurred boundaries and disruptive bodies reflects our uneasiness, and often our outright inability, to handle the demands of the ill. This inability is historically well-documented, ranging from 19th-century accounts of the “rest cure” to the ship of fools in Foucault’s History of Madness to Susan Sontag’s writing on AIDS. And yet, Bellamy’s account of the contemporary sick doesn’t quite fit with those previous examples. We are far, also, from the kind of pain that Elaine Scarry wrote about, for example, in The Body in Pain, in the 1980s. Scarry wrote about the body as a victim of torture, or a casualty of war. Bellamy’s subjects, on the other hand, make much smaller claims. These bodies don’t have to experience extreme forms of suffering to recognize their own reality: just feeling “nauseous in [the] stomach” is a sign of being “alive.” Her investigation is in the realm of Don DeLillo and his Airborne Toxic Event, or Todd Haynes’s Safe, a landmark in the cinematic representation of environmental illness, and similar to the sick bodies Rebecca Curtis has been writing about in her excellent stories in The New Yorker and n+1. Curtis’s characters, like Bellamy’s sick bodies, endure vague symptoms and are afflicted with diseases like “Fish Rot,” whose reality is consistently in question.

Like Curtis, Bellamy is examining a new era of sickness — the era of brain fog, let’s call it. The symptoms are “headaches, burning eyes, asthma symptoms, stomach distress/nausea, dizziness, loss of mental concentration and muscle pain. Some individuals also suffer fever or even loss of consciousness. Motor skills and memory may be impaired.” This is paradigmatic 21st-century illness, whatever its identifiable roots in 19th-century neurasthenia or Freud’s hysteria, just to name a couple predecessors. Symptoms are numerous but indefinable, while the assailants are manifold and omnipresent.

The humor of the title piece, as well as its insight, is in taking the subject to its extreme conclusion, presenting a new era of demands, and thinking through the sociopolitical implications of contemporary sickness. By recognizing and acknowledging the demands that the sick make on the world, Bellamy also allows us to begin rethinking their status. Usually, it is the sick body that is subject to the world and its assaults. But Bellamy envisions a shift in power. What if we reversed the way that we understand the relationship between the world and the sick? What if the world was to become vulnerable to the whims of the sick, for once? What if we put ourselves in the hands of the disabled? Why don’t we give ourselves over to the vulnerability that, let’s face it, is in all of us? Part of Bellamy’s brilliance, as we see time and again in this collection, is imagining the possibilities and implications of subjecting herself to these demands. She doesn’t resist in the face of otherness. She bends; she listens; she gives herself over.

Bellamy is still interested in the destabilization of categories — who belongs with the sick and who doesn’t? This is reflected in her own identification with the unwell. After all, she goes to the meeting because she is herself experiencing strange symptoms and odd discomforts. “Am I one of them?” she wonders: “I have been sniffed and found wanting, I gave that woman brain fog — would anybody want to be one of them? But if I’m not one of them, what am I, what’s going on with me?”

She begins the essay by playing with the grammatical push and pull of “subject” — what are we subject to and what are we subjects of? — addressing an undifferentiated litany of questions to the reader: “Have you often had to lower the regular dose of prescription or over-the-counter medication or herbal supplements because you were too sensitive to normal doses do you avoid caffeine …” She implicates not only herself but us, too: Who hasn’t experienced some of these symptoms? In the 21st century are we the sick or the well?

This feeling of inclusivity within the realm of the sick is particularly significant in light of how often isolation is seen as a potential cure. Bellamy briefly recalls the final scene in Todd Haynes’s movie Safe, when Julianne Moore, who plays a woman suffering from environmental illness, moves into a safe house in a nontoxic community. It’s an igloo-shaped isolation tank, in which Moore lives alone, having left her husband and stepson. The final shot features Moore looking at herself in the mirror, repeating, “I love you”: self-empowerment through radical seclusion. In Haynes’s movie this ending makes sense — Julianne is following the dictates of the leader of this nontoxic community. He no longer even reads newspapers, because just knowing about the horrors of the outside world puts his immune system at risk. Bellamy, however, roundly rejects the call of total detachment; she goes out into the room and joins the meeting. Later, she writes about her experience, christens herself the Bandana Monster, imagines kids being warned of her frightening arrival. Bellamy is consistently exposing herself, both to the reader and to the community at large. Her tone also instigates an important affective shift. She makes us confront the discomfort we might feel around the sick without sentimentality, and without sparing them or us.

In “Barf Manifesto,” an essay published previously by Ugly Duckling Presse, Bellamy returns to the relationship between writing and the demands of the body. Here she discusses an uncategorizable autobiographical essay (or is it a poem?) by Eileen Myles titled “Everyday Barf,” in which Myles explores her relationship to her aging and dying mother. Barfing is a disruption of the everyday, but Myles also uses it to talk about the “gender-confused, a state of trans, of flux. The Barf is not so much anti-logocentric, anti-dichotomy, as outside the whole fucking system.” For both Myles and Bellamy, who are colleagues as well as friends, there is inherent value in the “outside.” Bellamy, however, isn’t just writing an appreciation of Myles’s concept; she is also expanding on it. In her essay, Bellamy recounts clogging the toilet at Myles’s house and desperately trying to pump the mess in a flimsy nightdress, while Myles berates her through the bathroom door. Shit keeps rising and Bellamy keeps pumping, loose breasts jiggling under the nightgown. If we’re thinking about the potentially disruptive power of bodily emissions, it’s as if Bellamy takes Myles’s The Barf and raises her The Shit.

In the midst of this bodily mortification, Bellamy thinks about caring for her own dying mother: she quotes Julia Kristeva, who posited that the vulnerable body “subverts the forward propulsion of the narrative arc, that fantasy of progress, resolution. […] [B]odily emissions nauseate because they aren’t alive yet they come from us, bodily emissions point up our mortality, our impending thingness.” Both Bellamy and Myles agree on the unspeakable erotics of caregiving, specifically between mothers and daughters. “The intensity of our caring had lesbian overtones,” Bellamy writes of her own mother. “And then at the end, when my mother needed me to hold her and touch her, it felt so much like we were in a lesbian relationship.” Caring for any body requires, perhaps, a blurring of boundaries, an erasure of categories. To subject yourself to the sick is to step outside traditional social parameters. In discussing the needs of the body, along with its humiliations, Bellamy subverts her own narrative, finding resolution in the very act of subjection to the demands of the physical self — and to that subjection’s correlative demands on literary form.

For Bellamy, like Kristeva, the demands of the body are inevitably linked to death and mortality, which, in turn, are connected to our “thingness.” One of the fears of sickness is how quickly we can transition from subject to object. Indeed, isn’t part of the terror in Safe and White Noise (and any story of illness) the idea of losing control of our own physical narrative? In the essay “Phone Home,” Bellamy returns to the death of her mother and the experience of caring for her at the end. The entire essay is structured around viewings of Spielberg’s E.T., which provides cinematic shorthand for one of the main issues in the piece — how alien, how other, the dying body is. Part of that alienness is linked with the body as object; E.T. was just a puppet after all. How do we reconcile ourselves with this strange body’s needs and desires? How do we care for this person who is quickly losing her personhood? E.T. actually allows Bellamy to come to terms with the scattered objects that accompany death, her mother’s body included. After her mother dies, Bellamy looks at the corpse but fails to recognize her mother in the coffin — “It’s a big doll,” she thinks. Of course, there are also her mother’s actual things to deal with: treasured diamond earrings, Tupperware containers, all those inanimate items that somehow become part of the person. Death doesn’t put an end to demands. Even bodies drained of soul have needs and expectations. In the process of reconciling herself to those demands, Bellamy recognizes that “thingness” is also a part of her. E.T., the doll we all eventually become, is a reminder of the “burden of otherness we’ve carried since we left the primal ooze of our mother’s body.” We all carry the burden of otherness; how can we deny those who have been dealt a heavier load?

In “Digging Through Kathy Acker’s Stuff,” Bellamy delves still deeper into the issues surrounding alienation, objecthood, and death. She recounts visiting Matias Viegener in 2006, hoping to come away with a piece of Kathy Acker’s jewelry. (Viegener, the artist’s executor, has promised Bellamy some keepsake.) In thinking about Acker after her death, Bellamy goes even further in exploring the demands of the disembodied. She recalls a Buddhist book, which explains, “all ghosts, no matter what they look like or what they own, are hungry. If you care for your ghosts you leave them offerings of food.” For Bellamy, even bodies that no longer exist have the right to insist on needs and desires. “This essay is food for Kathy,” she writes. She then quotes Acker on pain and its importance: “Pain exists because it means; the world is meaning. When you scream, it is love. Cry, darling; the earth has been parched for a long time. You will be cooled down.

The beautiful thing about Bellamy and this book is how readily and insistently she gives herself over. Indeed, as the Buddhist book instructs, she makes a practice of it. She writes, “The dead are uncontainable, all we can do is greet them, allow them their otherness. Hello, Kathy, I humble myself before your otherness, an otherness I will never comprehend. I promise I won’t even try.” Over and over, Bellamy confronts the question of dealing with the other, and defers to it, acquiescing to its many demands. Her response is radical without being uncritical. She is not afraid to tell us, in the very next sentence, “I didn’t like Kathy.”

Of course, this question of dealing with the other is nothing if not political. Bellamy finally and inevitably makes this turn in her last essay, “In the Shadow of Twitter Towers,” about the recent relocation of Twitter headquarters to her neighborhood in San Francisco. Tech-driven gentrification has changed both the architectural and the natural landscape of the city as well as its population. Bellamy grieves the loss of the bohemian class, which is moving out to more affordable pastures in Oakland, Brooklyn, Detroit, even Cincinnati. The focus here, however, is on the homeless, who inhabit another kind of “otherworldliness.” These are men and women ousted from their neighborhoods, sometimes literally hosed off the streets (“once at 4AM and again at 6AM”). Like the sick (sometimes they’re one and the same), this is another social body that makes inconvenient demands. In this case, the demand is for the right to exist. Bellamy quotes a man kicked out of a neighborhood in San Francisco, who asks: “What do they want us to do? Float in the air? Everybody’s got to be somewhere.”

It is precisely the homeless body’s demand to be rather than to disappear that is inconvenient for us. If ghosts are hungry, at least they don’t take up a lot of space. The homeless, on the other hand, are frustratingly present, persistently visible or audible, shouting obscenities, carting their belongings through the street. They urinate and defecate publicly, remaining visible even when not actually present. They don’t exactly jive with Twitter’s image. Or Facebook’s or Yahoo’s or Google’s. So the homeless are steadily pushed out and replaced by drone-like techies, who barely interact with the world at all, preferring to blankly stare at their screens. Bellamy works hard to make the connection between the proliferation of the homeless and public policy clear. She cites Reagan’s massive social funding cuts, as well as San Francisco’s mayor Edwin Lee’s, the political prioritization of corporations over people. In this final essay, the demands of the body explicitly become a question of politics.

Bellamy works hard on this question. She does research on “gentrification, and homelessness.” She gathers facts, histories, laws, and statistics. But she still has to ask: “How much do I have to read in order to have the right to write about these people?” As she implies in the second half of the essay, knowledge is not nearly enough. Nor is writing. Bellamy ends the book with an anecdote about a man named Trey threatening a homeless woman who picks a branch off a tree. Bellamy fails to stand up for the woman and fumes about her own failure. She writes: “I should have raced to the street and told him to shut the fuck up, I should have given her money, I should have called the cops and reported his threatened assault.”

In her regret, Bellamy turns her attention back to form and to fantasy, granting this homeless “urban witch” and her branch magical powers. The witch taps her branch and poof, Trey is punished; she taps it again and poof, the “street-cleaning hoses are transformed into fountains that nourish San Francisco.” It’s an ending that once again allows Bellamy to switch the usual balance of power — and poof — she’s also switched genres: the grim realities of gentrifying San Francisco become, with the tap of the branch, a fairy tale.

This ending feels like an admission of defeat. Bellamy’s final wish is that “every single person in San Francisco nestles at night full-bellied, enveloped in softness.” It’s a pretty image, but it’s also a lullaby in the face of frustration and powerlessness. For a book that celebrates writing as a political act, this seems like a desperate last move, and it’s tempting to wonder: what good is this happy ending?

The impulse is understandable, though, and even logical, given Bellamy’s blurring of the boundaries between the alien and us, her desire to bring that otherworldliness closer. If we are paying attention, we will have recognized ourselves in the sick, the homeless, and the dying many pages ago. We are they — and we deserve a rest.

¤

Medaya Ocher is the Managing Editor of LARB.