Rachel Cusk is the author of the acclaimed Outline trilogy (Outline, Transit, and Kudos). She has also written three memoirs — A Life’s Work, The Last Supper, and Aftermath — and several other novels: Saving Agnes, winner of the Whitbread First Novel Award; The Temporary; The Country Life, which won a Somerset Maugham Award; The Lucky Ones; In the Fold; Arlington Park; and The Bradshaw Variations. She was chosen as one of Granta’s 2003 Best of Young British Novelists and has since been shortlisted for the Folio Prize, Scotiabank Giller Prize, and Goldsmiths Prize. She lives in London.

Rachel Cusk

A woman on a plane listens to the stranger in the seat next to hers telling her the story of his life: his work, his marriage, and the harrowing night he has just spent burying the family dog. That woman is Faye, who is now on her way to Europe to promote the book she has just published. Once she reaches her destination, the conversations she has with the people she meets – about art, about family, about politics, about love, about sorrow and joy, about justice and injustice – are the most far-reaching questions human beings ask.

These conversations, the last of them with her son, rise dramatically and majestically to a beautiful conclusion.


Kudos completes Rachel Cusk’s trilogy with overwhelming power. The trilogy is one of the great achievements in fiction.

Kudos

Kudos was the summer 2018 LARB Book Club pick. To join the Book Club, where we put you in conversation with editors and members and send a copy of the selected title to your door, <a href="https://shop.lareviewofbooks.org/join">become a LARB Friend member today</a>. 
¤ 
“In her effort to expose the illusions of both fiction and life, [Rachel Cusk] may have discovered the most genuine way to write a novel today.” – Ruth Franklin, The Atlantic 
 
Cusk is one of the “women... shaping the way we read and write fiction in the twenty-first century.” – The New York Times Book Review 
 
A woman on a plane listens to the stranger in the seat next to hers telling her the story of his life: his work, his marriage, and the harrowing night he has just spent burying the family dog. That woman is Faye, who is now on her way to Europe to promote the book she has just published. Once she reaches her destination, the conversations she has with the people she meets — about art, about family, about politics, about love, about sorrow and joy, about justice and injustice — are the most far-reaching questions human beings ask. 
 
These conversations, the last of them with her son, rise dramatically and majestically to a beautiful conclusion. 
 
 
Kudos completes Rachel Cusk’s trilogy with overwhelming power. The trilogy is one of the great achievements in fiction. 
¤ 
Rachel Cusk is the author of Outline and Transit, the first two novels in her trilogy, as well as the memoirs A Life's Work, The Last Supper, and Aftermath. She has also written several other novels: Saving Agnes, winner of the Whitbread First Novel Award; The Temporary; The Country Life, which won a Somerset Maugham Award; The Lucky Ones; In the Fold; Arlington Park; and The Bradshaw Variations. She was chosen as one of Granta's 2003 Best of Young British Novelists. She lives in London. 
¤ 
To view all Book Club picks, please visit the <a href="https://lareviewofbooks.org/feature/larb-book-club/">LARB Book Club</a> page.

“Kudos” by Rachel Cusk

LARB Quarterly, no. 40: Water

LARB publishes daily without a paywall as part of our mission to make rigorous, incisive, and engaging writing on every aspect of literature, culture, and the arts freely accessible to the public. Help us continue this work with your tax-deductible donation today!

Did you know LARB is a reader-supported nonprofit?

Subscribe to the LARB newsletters.

Sign up for our newsletter.

Frank Bergon is a novelist, critic, and essayist whose writing focuses primarily on California and the American West. He has published 12 books, most recently a memoir about his Basque American heritage, The Toughest Kid We Knew (2020). His novel Jesse’s Ghost was selected in 2024 for The New York Times’ “Best Books About California.” He is an emeritus professor of English at Vassar College.

Frank Bergon

APRIL IS NATIONAL Poetry Month, and on April 23—celebrated as National Talk Like Shakespeare Day in honor of the dual anniversary of Shakespeare’s birth and death—we’re encouraged to speak like the Bard and his characters. This playful task becomes both challenging and illuminating in face of perhaps the most puzzling speech in all of Shakespeare’s plays, typically heard as gibberish except in a few places, like rural California. 
 
Shakespeare toys with numerous European languages throughout his work, including Italian, French, Spanish, and Dutch. Often, these are spoken in thick accents, with comedic pronunciation. The same holds true for his use of the various British dialects—Scots, Welsh, Cornish, and Irish—heard in scruffy taverns or high courts. In Henry V, soldiers fracture the King’s English while the king himself and a French princess descend into a comical Franglais courtship. Yet, no matter how garbled the speech, playgoers can usually identify distinct languages and dialects—that is, until they bump up against what scholars have called the “invented language,” “unintelligible gabble,” and “‘Boskos thromuldo boskos’ mumbo-jumbo” in his comedy All’s Well That Ends Well. 
 
Here’s the situation: seeking to fool a potential traitor, a French lord and some soldiers make what seem to be nonsense sounds, as though speaking a foreign language only they can understand. While the possible traitor, Parolles, “hath a smack of all neighboring languages,” he’s unable to make sense of the lord and soldiers’ conversation, and mistakenly concludes that his captors are Muscovite mercenaries speaking Russian, which he doesn’t know. He wishes a soldier would use German, Danish, Dutch, Italian, or French so he’d be able to understand: 
 
ACT IV 
SCENE I. Without the Florentine camp. 
Enter Second French Lord, with five or six other Soldiers in ambush. […] 
Sec. Lord. Throca movousus, cargo, cargo, cargo. 
All. Cargo, cargo, cargo, villianda par corbo, cargo. 
Parolles. O, ransom, ransom! do not hide mine eyes. 
They seize and blindfold him. 
First Soldier. Boskos thromuldo boskos. 
Par. I know you are the Muskos’ regiment; 
And I shall lose my life for want of language: 
If there be here German, or Dane, low Dutch, 
Italian, or French, let him speak to me. […] 
First Sold. Boskos vauvado: I understand thee, and can speak 
thy tongue. Kerelybonto […] 
Par. O! 
First Sold. O, pray, pray, pray! Manka revania dulche. 
Sec. Lord. Oscorbidulchos volivorco. […] 
First Sold. Acordo linta. […] 
Exit, with Parolles guarded. A short alarum within. […] 
SCENE III. The Florentine camp. 
Enter the two French Lords and some two or three Soldiers. 
First Lord. Hoodman comes! Portotartarossa. […] 
First Sold. Bosko chimurcho. 
First Lord. Boblibindo chicurmurco. 
Some of these invented words in the play may correspond to actual neo-Latin words from Italian, Portuguese, Catalan, and Spanish, but these are few. Yet several phrases strike the ear as Basque, a language I grew up hearing in the San Joaquin Valley. 
¤ 
In Shakespeare’s time, Basque was spoken on both sides of the Pyrenees, as it is now in four provinces of Spain and three in France. It survives today as the oldest language in Europe, with no connection to any other language in the world. Basques call their language Euskara; a speaker of Basque is called an Euskaldun. 
 
Like many Basque Americans, I came late to a clear understanding of my heritage. I knew from a young age my ancestry was Basque, and published a short story in my high school magazine about a Basque sheepherder who lost his band in a San Joaquin Valley flood. I’ve since written four novels about Basque American characters. In a book of essays and a memoir, I wrote about Basque friends, as well as my own Basque family—in Nevada, where I was born; in the California ranch country where I grew up; and in the Basque Country itself, where I continue to visit and keep in touch with relatives. 
 
Still, a broader understanding of Basque history and culture eluded me until recently, and my awareness continues to expand with ongoing discoveries. Just as a recent genealogical test interpreted my DNA as 98 percent Basque, archaeologists in 2015 discovered that <a href="https://www.pnas.org/doi/10.1073/pnas.1509851112">some modern Basques share DNA links with ancestral Basque farmers</a> buried 3,000 years before the Roman Empire. When Romans encountered these ancient people in the first century, they identified them with Latin terms like Vascones or Vasconum. (I didn’t know why the Romans came up with these names for the inhabitants in my grandparents’ ancestral homeland until I started work on my memoir. Then, I dusted off my high school and college Latin and Greek to discover that early Roman historians were phonetically reproducing what the local inhabitants called themselves.) 
 
Two thousand years ago in his Geography, the Greco-Roman historian Strabo recorded the earliest surviving names of these pre-Roman people as Οὐασκώνων and Οὐάσκωνας. The Roman historian Livy called them “Vasconum.” In the next century, Ptolemy wrote “Ouascones”; others wrote “Vascones.” Despite differences in appearance, the words have similar sounds if we remember that v in Latin was probably pronounced like a soft w or ou. Both the Greek (Ouaskonas) and Latin (Vascones) become close phonetic spellings of what an early 20th-century Basque woman like my grandmother might have called herself in her Markina dialect: “Ouskunan,” or “Euskunan,” meaning someone who speaks Euskara. 
¤ 
Even now, the survival of this ancient language remains as mysterious as its origin. As recently as the summer of 2021, archaeologists discovered the oldest authenticated writing in the language of ancient Vascones <a href="https://www.smithsonianmag.com/smart-news/words-etched-into-an-ancient-bronze-hand-hint-at-the-mysterious-origins-of-the-basque-language-180981153/">on a flat bronze hand</a> probably hung from the door of a house 2,100 years ago. The artifact was inscribed with approximately five words; the first word, “sorioneku,” is a forerunner of “zorioneko,” spoken by modern Basques to mean “good luck.” Except for a few other surviving fragments of early writing in the form of letters, songs, charms, and proverbs, Euskara remained primarily an oral language for centuries. The first book in Basque, a collection of religious and secular poems by Bernard Dechepare (Bernat Etxepare in Basque), was published in 1545, only 19 years before Shakespeare was born. 
 
During the 16th century, Basques were known less as writers than as Europe’s earliest whalers, who taught the skill to the English, Dutch, and Danish. Basques fished for cod as far away as the Newfoundland coast and maintained tryworks for processing whale blubber in Labrador. In 1534, after the French explorer Jacques Cartier sailed to the Gulf of Saint Lawrence and claimed the “New Land” for France, he encountered natives who knew Basque words and expressions. Most ships sailing across the Atlantic from Spain to the Americas were built in Basque shipyards. Iron mines and foundries south of the Pyrenees, especially those of Bilbao (Bilbo in Basque), had long been the main European suppliers of metal for shipbuilding, as well as for nails, anchors, farm tools, firearms, and swords. In The Merry Wives of Windsor, Shakespeare uses the Basque word “bilbo” to denote the famous sword of flexible steel. In Hamlet, iron shackles are called “bilboes.” 
 
An early comedy, Love’s Labour’s Lost, takes place in the Basque areas of Basse-Navarre and Béarn. The main characters in the play are based on historical figures—namely Henri of Navarre, later King Henry IV of France, whose mother, Jeanne d’Albret (Joana Albretekoa in Basque), not only had the New Testament translated into Basque for her subjects in 1571 but also tried to institute Euskara as the region’s official administrative language. 
 
Basque regions again play a role in All’s Well That Ends Well when the heroine, Helena, shadows her runaway husband from France to Italy. The fanciful plot of Shakespeare’s folkloric source requires Helena to be in Florence, disguised as a barefoot penitent. The source doesn’t mention, yet Shakespeare does, that she’s purportedly on her way “To Saint Jacques le Grand” at Compostela in Spain—that is, the Camino de Santiago and its trails through the Basque Country to the shrine of Saint James the Apostle. In the mid-12th century, the French cleric Aymeric Picaud circulated a travel guide for pilgrims and recorded in his journal the earliest known glossary of what was, in his censorious view, the “barbarian language” of Basques as opposed to “Christians.” By the time of Shakespeare’s birth, pilgrims had encountered Basques for seven centuries on their way to what had become the most visited shrine in Europe. 
 
Meanwhile, north of the Pyrenees for 250 years until the mid-15th century, Basque ships and sailors from Bayonne hauled wine from Gascony to England. (The words “Gascons” and “Vascones” share the same Latin root.) Gascon merchants and Basque shippers stayed at ports and fairs in the cities of Bristol, Sandwich, and especially London for up to three months to sell wine and salt before sailing home with grain and hides. Despite English suspicions about aliens and their unintelligible tongues, the lucrative wine trade allowed “Gascon-speakers” to stay longer than other foreigners—and to live where they wanted. By Shakespeare’s time, some remained permanently as “Gascon émigrés.” 
¤ 
Until now, the mystery of Shakespeare’s “gibberish” has gone unsolved in part because it doesn’t look like Euskara. For starters, the Basque alphabet doesn’t use the letters c, q, v, w, or y. Transcribed into the Basque alphabet, though, the babble in the play begins to look like misspelled Euskara: 
 
Troka mobutzus, kargo, kargo, kargo. 
Kargo, kargo, kargo, biliando par korbo, kargo, 
Boskos tromuldo boskos. 
Boskos baubado. 
Kerelibonto. 
Manka rebania dultxe. 
Otzkorbidultxos boliborko. 
Akordo linta. 
Portotartarotza. 
Bosko tximurtxo. 
Boblibindo txikurmurko. 
I sent the original passages to native speakers, professors, and translators in the Basque Country and in the United States. Everyone confirmed that, while they couldn’t hear any actual Euskara words, they did hear its sounds. At Mondragon University, Professor Monika Madinabeitia read the lines to six colleagues and 10 students from places in the Basque Country with differing dialects. The professors noted nine places in the reading that sounded Basque. The students agreed, particularly on those with the tx-sound of ch. “Euskara is a very sibilant language,” Monika emailed, “and there are loads of [z] [s] [tz] [tx] sounds. These are the ones that sounded like Basque to my students.” Amaia Gabantxo, a translator of several Basque books, summed up the consensus of my various respondents by observing that “some of the syllabic progressions in those ‘words’ do sound like Basque to someone who doesn’t understand or speak it. It would seem that it is an attempt at something that sounds like Basque.” 
 
For me, the clincher is the way Shakespeare emphasizes the word “Boskos.” From Latin came the words “Vascos” in Spanish and “Basques” in French and later English. Their similarity in sound is apparent when we remember that v in Spanish is pronounced much like b. Growing up in rural California, I regularly heard those of my ethnicity called “Bascos.” In All’s Well That Ends Well, Parolles, “the manifold linguist,” thinks the soldiers are Russian-speaking “Muskos.” But he’s wrong. Their shouted response implies the correction: No, we’re “Boskos.” And, in case we miss the phonological significance of “Muskos” and “Boskos,” Shakespeare repeats the word four times: “Boskos […] boskos […] Boskos […] Bosko.” 
 
I think he knew what he was doing: capturing the sound of a rare, ancient language, surviving nearly intact today—the speech of Basques. On National Talk Like Shakespeare Day, it might be best to listen. After all, Shakespeare had a good ear. 
¤ 
Some context has been adapted from Frank Bergon’s The Toughest Kid We Knew: The Old New West (2020), <a href="https://unpress.nevada.edu/9781948908641/the-toughest-kid-we-knew/">available now</a> from University of Nevada Press.

I Understand Thee, and Can Speak Thy Tongue: California Unlocks Shakespeare’s Gibberish

Evan Thompson is a professor of philosophy at the University of British Columbia Vancouver and a fellow of the Royal Society of Canada. He is the author or co-author of five books in cognitive science and philosophy, including The Embodied Mind: Cognitive Science and Human Experience (1991).

Evan Thompson

Adam Frank is the Helen F. and Fred H. Gowen Professor in the Department of Physics and Astronomy at the University of Rochester and a winner of the Carl Sagan Medal. He is the author of Light of the Stars: Alien Worlds and the Fate of the Earth (2018).

Adam Frank

Marcelo Gleiser is the Appleton Professor of Natural Philosophy at Dartmouth, the 2019 Templeton Prize laureate, and the author of seven widely translated books, most recently The Dawn of a Mindful Universe: A Manifesto for Humanity’s Future (2023).

Marcelo Gleiser

The Blind Spot: Why Science Cannot Ignore Human Experience

Robert P. Crease is a professor in the Department of Philosophy at Stony Brook University. He writes a monthly column for Physics World on the historical, philosophical, and social dimensions of science. In 2021, he won the Lord Kelvin Medal and Prize for “describing key humanities concepts for scientists and explaining the significance of key scientific ideas for humanists.” His latest book is The Leak: Politics, Activism, and Loss of Trust at Brookhaven National Laboratory (with Peter Bond; MIT Press, 2022).

Robert P. Crease

THIS BOOK’S AMBITION is breathtaking. The three authors of The Blind Spot: Why Science Cannot Ignore Human Experience (2024) argue that it is urgent to change the science-shaped worldview that permeates our political, economic, and social systems. “[O]ur collective future and human project of civilization are at stake,” they warn in the book’s opening sentence. 
 
Adam Frank and Marcelo Gleiser are eminent physicist-astronomers, and Evan Thompson is a prominent philosopher and cognitive scientist. They take us through several fields, from relativity and quantum mechanics to cognitive and planetary science, outlining the spectacular progress that scientists have made in these areas of study, along with the intractable puzzles they have encountered—puzzles that spring from the scientific picture that guides our thinking, according to which the world is fully describable in objective terms. 
 
The Blind Spot turns the tables on the scientific worldview by insisting that experiencing the world precedes being able to practice science. “We must live the world before we conceptualize it,” the authors say. Recognizing this does not mean that science loses its authority—rather, it gains its “proper footing.” The discussion is so clear, well paced, and witty that I’d be tempted to describe it as a breezy read if that didn’t risk coming across as a slight. Nonscientists will appreciate sparklingly clear accounts of seemingly forbidding concepts such as phase space, quantum mechanics, and the integrated information theory of consciousness. The authors guide us through conventional understandings of scientific concepts to illustrate why they feel so powerful methodologically to scientists—to the point that the concepts come to substitute for experience and replace the world with our intellectual reconstructions of it. Scientific concepts and theories effectively get a grip on the workings of nature, but the “Blind Spot” occurs when these are taken to be more real than the experience on which they are based. The book doesn’t fit any existing genre; it’s not an academic or popular book about either science or philosophy but draws from each genre to make its argument. 
 
Frank, Gleiser, and Thompson take as their jumping-off point philosopher Edmund Husserl’s remark, in The Crisis of European Sciences and Transcendental Phenomenology (1936), that the West has both flourished because of and been afflicted by the “surreptitious substitution” of theories and ideas for the world itself. We bifurcate the world into what is “out there,” and thus objective, and what is “in here,” and thus subjective, regarding the first as what’s real and our experience as a mere glimpsing of it. This problem has only gotten worse, the authors claim: scientists can act like compulsive cartographers caught up in a Borgesian quest to map not only the world but also their own mapping of the world—a task that eventually creates Escherian impossible objects if it tries to avoid the Blind Spot. “[Y]ou cannot be a mapmaker if you cannot see what you are mapping,” they write. Their book points out where and why scientific mapping breaks down, and the dire consequences of this. “Husserl’s crisis,” they say, “is still our crisis.” 
 
The authors use “Lived Time” versus “Clock Time” to show how surreptitious substitution works. You are living time’s flow, right now, in the process of reading these words. That’s an illusion, say some prominent physicists; time is a variable in equations, a series of measurable instants, and while this series is highly unlikely to go backwards (other equations tell us why), it potentially can. If time seems like a forward flow to us, it is because our imperfect mental and bodily instruments blur what’s really happening. The authors, however, show that our experience of time is primordial. A clock measures a succession of moments, but only experiencing duration enables us to recognize this as a succession. Timekeeping devices do not measure time by themselves: a person uses clocks to mark out the temporal duration that the person is already experiencing. Clocks don’t tell time; people do. Nobody pulls out a clock to know what time is, only what time it is. 
 
The authors then train their lens on problems elsewhere: the “twin paradox” in relativity theory, in which two siblings age differently because one takes a trip in a rocket; “Loschmidt’s paradox,” on the impossibility of proving time’s irreversibility; and the various paradoxes that fill the “opulent basket of weirdness” that is quantum mechanics. In each case, the authors show how these paradoxes result from either trying to avoid talking about experience or trying to turn it into an object. In biology, the authors point out the impossibility of the attempt to begin with mechanistic conceptions and end up with the categories of life, a method that conflates physical dynamics with living. “Biology presupposes life’s experience of itself,” they say, for “it takes life to recognize life.” In cognitive science, the authors demolish an entire series of attempts to treat thinking as a form of computing. 
 
Many of The Blind Spot’s arguments and positions are not new. Philosophers since Immanuel Kant—especially Husserl, Henri Bergson, and Alfred North Whitehead—have demonstrated the fundamental role of the mind in our picture of the world. Despite these thinkers’ efforts, though, the “Blind Spot worldview” has so deeply saturated Western thinking that their arguments have barely dented our natural attitude. We might come to understand the philosophical arguments but then return to our habitual assumption that experience is ephemeral, or at least irrelevant to real science. What’s innovative about The Blind Spot is that the authors focus on the problems that scientists create for themselves by such an assumption. 
 
The authors return, again and again, to the notion that experience is fundamental but cannot itself be made an object, making the discussion a little repetitive. The phrase “surreptitious substitution” occurs over four dozen times. Yet the repetition is helpful: the Blind Spot worldview has been cemented by four centuries of extraordinary successes, and practices such as defining human intelligence as mere cognition. Recently, after a head injury, I was given a test to see if my mind had been adversely affected. Yet the test didn’t check my intuition, my ability to grasp metaphors or appreciate the meanings of texts; instead, my mind was pronounced sound because I could predict what shapes fit where, sort through simple logical problems, and come up with a certain number of words that began with “g.” 
 
The authors navigate the difficult task of drawing our attention to direct experience—what allows things to appear and makes the world available to us—without turning it into an object or explainable thing itself. The awkwardness involved sometimes leads them to appeal to wonky terms such as “mindful meta-awareness” and “suchness,” making the book at times sound metaphysical or even mystical. But this struggle to bring the role of experience to light is precisely the point; it clashes with the human urge to explain rather than experience. 
 
The book’s most ambitious punch comes at the very end, when the authors link the Blind Spot with the inability to recognize and deal with climate change. Their position is counterintuitive: one would think that refusing to admit climate change (and do anything about it) amounts to rejecting science based on ignorance, self-interest, or political hypocrisy. All of that is a sideshow, according to the authors. The failure to address climate change is actually driven by a view of the Earth as consisting of objectifiable things and of human action as driven by quantifiable values, amplified by the codependence of Western science and capitalism. That’s why it will take more than geoengineering and carbon caps to save the planet. 
 
The Blind Spot uses philosophical arguments to resolve scientific puzzles that threaten the integrity of science itself. We philosophers have long dreamed of finding a way to demonstrate the interdependence of the sciences and the humanities. Well, here it is.

What Scientists Can’t See: On Adam Frank, Marcelo Gleiser, and Evan Thompson’s “The Blind Spot”

Melina Moe is the curator of literature at Columbia University’s Rare Book &amp; Manuscript Library.

Melina Moe

“I FOUND IT extremely honest, forthright, and moving in ways I had not expected it to be,” Toni Morrison wrote to an aspiring novelist in 1977, “but it is a shuddering book and one that offers no escape for any reader whatsoever.” Still, Morrison, then a senior editor at Random House, liked the manuscript so much that, before responding, she passed it around the office to drum up support. The verdict was “intelligent,” but also “very ‘down,’ depressing, spiritually abrasive.” Whatever the merits of the writing, Morrison’s colleagues predicted, the potent mix of dissatisfaction, anger, and mournfulness would limit the book’s commercial appeal—and Morrison reluctantly agreed. “You don’t want to escape and I don’t want to escape,” her letter concludes, “but perhaps the public does and perhaps we are in the business of helping them do that.” 
 
During her 16 years at Random House, Morrison wrote hundreds of rejection letters. Usually typed on pink, yellow, or white carbonless copy paper, and occasionally bearing Random House’s old logo and letterhead, these are now filed among her correspondence in the Random House archives at Columbia University’s Rare Book &amp; Manuscript Library. While many of the letters were mailed to New York, Boston, and even Rome, others were sent to writers in more obscure places; some are addressed to “general delivery” in various small towns across the United States. 
 
Regardless of destination, Morrison’s rejections tend to be long, generous in their suggestions, and direct in their criticism. The letters themselves—generally one, two at most, exchanged with a given writer—constitute an asymmetrical archive. On one end of each communiqué is the ghost of a submitted manuscript (absent from the archive after being returned to the sender, although in some cases survived by a cover letter). On the other is a rejection from Morrison, sometimes brusque yet typically offering something more than an expression of disinterest—notes on craft, character development, the need for more (or less) drama. But also: Autopsies of a changing, and in many ways diminishing, publishing industry; frustrations with the tastes of a reading public; and sympathies for poets, short story writers, and other authors drawn to commercially hopeless genres. 
¤ 
Most of Morrison’s surviving rejection letters date to the 1970s, a period that saw rapid changes in New York book publishing. This was especially true at Random House: a decade after going public in 1959, the company used the influx of cash to fuel a wave of acquisitions and two mergers, purchasing Alfred A. Knopf and Then, in 1965, Random House itself was acquired by RCA, an electronics company, only to be sold a few years later to a media conglomerate owned by the Newhouse family. Under this aegis, Random House went on to acquire a slew of imprints that expanded the company’s global footprint and generic range. 
 
In short, like Pangaea breaking up in reverse, the publishing industry underwent the dramatic, global consolidation that produced today’s “Big Five”: Simon &amp; Schuster, Penguin Random House, HarperCollins, Hachette Book Group, and Macmillan. Recently, this would have shrunk to the Big Four had <a href="https://www.publishersweekly.com/pw/by-topic/industry-news/industry-deals/article/85004-bertelsmann-to-buy-s-s-for-2-2-billion.html">an attempt by the German media conglomerate Bertelsmann</a> (owner of Penguin Random House, the largest US publisher) to buy Simon &amp; Schuster from its parent company, ViacomCBS, not been blocked by a US federal judge on antitrust grounds. Assistant Attorney General Jonathan Kanter <a href="https://www.nytimes.com/2022/10/31/books/penguin-random-house-simon-schuster.html">celebrated the collapse of the deal,</a> claiming: “The proposed merger would have reduced competition, decreased author compensation, diminished the breadth, depth, and diversity of our stories and ideas, and ultimately impoverished our democracy.” 
 
Kanter’s statement may seem grandiose, but the underlying anxiety is and was real; Morrison herself voiced similar concerns 40 years earlier. In her 1981 keynote speech at the American Writers Congress, she warned that the business had already tipped too far away from the work of writers and editors, so that “the vitality in the arts which promoters like to talk about is false. Beneath the headlines of blockbusters and bestsellers, underneath the froth of the book fairs,” she averred, “something is terribly wrong.” 
 
It’s perhaps unsurprising that the conditions of for-profit cultural production tend to reward the precisely honed, predictable commodity. Literary scholar Dan Sinykin recently argued that the conglomerate era in publishing has transformed the fictional works that get acquired, published, and placed (strategically) on store shelves. “Conglomerate fiction,” which is often genre fiction—that is, more or less easily labeled as mystery, romance, or science fiction—is less distinguishable by its formal characteristics than by its origins within a “conglomerate superorganism” of marketers, acquisitions editors, dust-jacket designers, and many others whose jobs are on the line and therefore have a stake in a given book’s success. The shift hasn’t been unique to fiction. If the conglomerate era produced corporate authors, <a href="https://www.sup.org/books/title/?id=21461">the studio system</a> churned out Hollywood blockbusters, while <a href="https://www.hup.harvard.edu/books/9780674062092">creative writing programs</a> shaped a distinctly reflexive MFA style. Even so, Morrison’s warning about the state of publishing in 1981 didn’t advocate a return to the solitary, romantic toiler. Instead, <a href="https://www.nytimes.com/1981/10/10/arts/writers-congress-opens-with-calls-for-solidarity.html">her keynote address called for movement building</a>: “We don’t need any more writers as solitary heroes. We need a heroic writers movement—assertive, militant, pugnacious.” 
¤ 
Morrison’s letters are unexpectedly forthcoming. Often, she supplements her rejections with diagnoses of an ailing publishing business, growing frustrations with unimaginative taste, the industry’s aversion to risk-taking, and her own sense of creative constraint working at a commercial press (especially in the late 1970s and early ’80s; Morrison left editorial work to be a full-time novelist in the early 1980s). They sketch a “road not taken” in mainstream publishing, as experimental volumes, poetry, and short story collections were increasingly treated as suspect investments of editorial time and publishing house resources. Current market conditions made for “a losing proposition for the publisher and a hopeless one for short story writers,” Morrison informed one author, and unless they were penned by famous novelists, short story collections were “almost like the publication of poetry”—that is, “practically impossible to make a profit from.” In another, lengthy letter from 1977, Morrison outlined how the economics of a book project depended on the mechanisms of distribution. It wasn’t just that casual readers didn’t buy short story collections, but that the major institutions responsible for generating widespread enthusiasm and name recognition were also uninterested: “Book clubs do not make offers for collections of short stories; mass paperback houses do not make offers for collections of short stories by single authors and so we are left with the hope that ten or fifteen thousand people will go into a bookstore and ask for a particular author by name.” The rejection concludes with Morrison’s admission that “[t]here is no point in my being other than honest with you, you should continue to publish in magazines and if you ever decide to write a novel, I’d be delighted to look at it.” 
 
With other projects, Morrison tried to tap into available marketing networks. She wrote to Good Housekeeping in the hopes they would select Lucille Clifton’s Generations (1976) for their book club, as well as to dozens of Black cultural organizations to see if they would organize reading clubs for Angela Davis’s autobiography. Despite being met with middling success, these campaigns—as well as Morrison’s work on the genre-bending Black Book (1974)—fueled an increase in queries from West Coast, experimental voices. Morrison was humane even with the most hopeless of proposals, like those she received from aspiring crossover academics. In 1978, Morrison told a Berkeley professor that the “commercial requirements of Random House are such that literary research and criticism does not figure in its plans.” Still, Morrison’s letter suggests that she’d read the entire manuscript, providing suggestions and the consolation that “unless you have some very ‘hip’ (and probably inaccurate) sociological view to tag on to the literary criticism, it is received with very little enthusiasm.” Similarly, Morrison wrote an apologetic note to Wayne Daniels and Ishmael Reed after passing on a <a href="https://www.nytimes.com/1976/02/01/archives/four-yardbirds-the-guest-word.html">Yardbird</a> reader in 1974, explaining that “the financial crisis that has swept the country has now gripped everybody in publishing and any project on which there is a modicum of risk is heavily discouraged.” She nonetheless offered to “do whatever [she could] to promote it,” asking for copies she could use to “generate some enthusiasm on this coast.” 
 
Morrison was keenly aware that the publishing world, like other areas of business, is a place where it helps to have friends and connections, industry contacts and people who may owe you (or someone you know) a favor. To that end, she occasionally ended a rejection by offering her name as a kind of passport with which hopeful authors might navigate the borders erected by other cultural gatekeepers. In 1977, she advised one young writer to find an agent and directed him toward the legendary literary agents Georges Borchardt and Peter Matson, adding, “When you write to them you may say that although I could not take your manuscript myself, I was very much in love with it, and I’m willing to put it in writing.” She pointed another young radical in the direction of Jules Geller, a former colleague of Morrison’s who went on to work at the Monthly Review, and sent yet another to Charles Harris—a Black editor who overlapped with Morrison briefly at Random House before leaving to become a founding editor at Howard University Press. Even in her rejections, Morrison was building a network of Black writers and editors who might, one day, work to redraw the contours of commercial publishing. 
¤ 
Above all else, Morrison’s rejection letters focus on craft—that is, on the experience of reading a work under review. In one 1978 rejection of a modern Western, she wrote that “it simply wasn’t interesting enough—the excitement, the ‘gut’s, just weren’t there. I am returning it to you herewith.” This sustained desire to explain her rejections elicits a decades-long, fragmentary discourse on style, on how to advance a plot, on when a manuscript’s structure needs to be more unexpected, or—more commonly—on when it needs to be simplified. Readers are needy creatures, Morrison’s letters suggest, demanding both drama and organization, the space and information to make discoveries themselves yet a clear enough path so as not to feel lost. In 1975, she described one manuscript as “put together in a way that made it difficult to enjoy. The scenes are too short and packed too tightly. Motives were lacking.” She forestalled any possible rejoinders about the virtues of avant-garde abstraction by professing her awareness that “the subject itself is about disorder and confusion” but maintaining that “the book should create order for the reader, to help him understand more than simply what happened. He needs to know why.” In other words: Attempts to capture the condition of modern life are no excuse for leaving readers miserable, directionless, or bored. 
 
Editorial advice often boils down to show don’t tell, and literary critics like Ted Underwood, Andrew Piper, and Sinykin have argued that the language of sensory and embodied perception sets fiction apart from other genres, like biography. Morrison’s letters often bear this out. In 1979, she informed one writer that their “story is certainly worth telling,” but they “describe people and events from a distance instead of dramatizing them, developing scenes in which the reader discovers what kind of people they are instead of being told.” Vivid scenery and precise details offer readers room to maneuver, a way to discover a world that resonates. A couple of months earlier, she gave similar advice to a young Bebe Moore Campbell (who went on to become a best-selling author). And, addressing one colorful character who had evidently dropped by the Random House offices unannounced to pitch their memoir, Morrison warned about conflating an eventful life with a well-crafted story. “Your manuscript was no less interesting than you were,” she noted; however, to make it publishable, “you would have to add the artifice (or art) that you said you decidedly would not do.” 
 
What Morrison repeatedly stressed, trusting her exceptional acuity as both a reader and writer, is that writing is a skill of its own—one that doesn’t automatically follow from intellectual brilliance, nor from simply being an interesting or important person. She told one young writer that his ideas were good, but warned that concept was the first and lowest hurdle he would face: 
Your work needs force—some manner of making these potentially powerful characters alive and of giving texture to the setting. Giving details about the people—more than what they look like—what idiosyncrasies they have, what distinguished mannerism—and details about where the action takes place: what is in the room, what is the light like, the smells, etc.—all of that would give us texture and tone. 
Characteristically, this detailed rejection ends with encouragement, as Morrison told the author, “I hope you are able to work on [your manuscript] to give it the vitality it certainly deserves.” 
¤ 
Morrison left Random House in 1983. In the years leading up to her departure, she sought to make more time for her own writing by commuting to the office only once a week. Yet she continued to read unsolicited submissions. She apologized to one author for responding almost a year after her manuscript landed on her desk. (She found the submission “messy and disjointed” and had “no idea what or where a novel might be,” but nevertheless concluded that “there is such power and grit and a funny kind of lyricism that I have to tell you to try to make something of it”—and instructed the author to send it back to her when she had.) To an unpublished writer from South Webster, Ohio, Morrison observed that “there is a great deal of vitality in your writing and a freshness that is welcoming,” though, she warned, “it needs a lot of work with structure and dialog.” Even so, she promised to “give the entire manuscript a reading” if he finished. 
 
Remarkably, this was an offer Morrison extended repeatedly, to unpublished, unknown writers—some of whom had sent only a handful of what she believed to be promising pages. Unsurprisingly, her rejection notes are a practiced repertoire of graceful ways to say “no” and “goodbye”: “Enclosed herewith”; “I decline”; “Please accept my genuine regrets”; “Best of luck”; “With regards and regrets.” But they’re an archive of Morrison’s faith in and sheer love for the written word—and of her kindness. 
 
Throughout her career, Morrison balanced her literary commitments, her commercial responsibilities, and her concerns about the industry overall. The increasing friction between these likely contributed to her eventual decision to leave publishing entirely. Morrison’s rejection letters represent perhaps her clearest articulation of this tension, often for the benefit of young authors who had no claim on her attention other than throwing a piece of writing over the Random House transom. Such writers, she warned, faced uphill battles to get their words into print. “The material is interesting,” she concluded in one letter, “but not the writing: it needs a lot of work to give it the energy a story must have.” 
¤ 
Featured image: Alfio Giuffrida, <a href="https://commons.wikimedia.org/wiki/File:Wandtoepfe_A-exp11_Alfio_Giuffrida-AG_Sinnwerke.jpg">Wandtöpfe A-exp11</a>, 2020, is licensed under <a href="https://creativecommons.org/licenses/by-sa/3.0/deed.en">CC BY-SA 3.0 Deed</a> by the creator. Accessed February 26, 2024.

There Is No Point in My Being Other Than Honest with You: On Toni Morrison’s Rejection Letters

<h4 class="tb f173">David Hering is a critic, novelist and senior lecturer in English at the University of Liverpool. His writing has appeared in The New York Review of Books, Guernica, The Point, The London Magazine, and others. He is currently writing a book on haunting in contemporary culture.</h4>

David Hering

A MAN IS being murdered outside a child’s window. A prisoner of Auschwitz, he was caught fighting with another captive. As punishment, he’s being drowned in a river. We can’t see the incident, but the child can. He moves over to the window and looks out beyond our field of vision. Almost immediately, he withdraws back into the room, and utters a gnomic phrase: “Don’t do that again.” 
 
To viewers watching this scene, it’s unclear to whom this is directed: to the prisoners, to the toy soldiers with which the boy has been playing, or to himself. If it’s the prisoners, he has inculcated the values of the murderers who live in his house; he is the son of Rudolf Höss, the commandant of Auschwitz, whose home lies on the other side of the camp wall. If it’s the toys, his revulsion at the murder has been redirected to miniature avatars of those outside his window. Most likely, he is talking to himself, and the thing he must not do again is look at what’s happening next door. Better to stay indoors, on the other side of the wall, and withdraw into the make-believe narrative of his toys. The window, as so often occurs in The Zone of Interest (2023), the film from which this scene is taken, is a blinding white square covered by a gauzy curtain. Something awful we cannot see is happening, just out of sight. 
 
The Zone of Interest focuses on the everyday lives of the Höss family. We never see what happens inside Auschwitz, which appears only as a backdrop. Its towers loom above the concrete garden wall, the smoke from its chimneys spreads upwards into the sky, and human bones are washed downstream into the nearby river. We hear sounds of gunfire, screams, barked orders, and machinery, all of which play out over the Höss family’s domestic lives. Each day, Rudolf Höss leaves his house, murders countless prisoners, and comes home to read his children a bedtime story. There’s a word we might use for this juxtaposition of the domestic idyll and the death camp: “obscene.” But the word captures more than the camp’s utter depravity. It derives from the Greek, “ob-skeen,” which means offstage or out of sight, and Glazer’s film relies as a structural principle on a strict division between what is on- and off-screen. There is no on-screen act of violence in the film. Instead, its mise-en-scène is suffused with the horror of the systematic genocide taking place just out of sight, and Glazer uses the dramatic language of the “ob-skeen” to view the Holocaust—a historical obscenity whose visual depiction has been fraught with difficulty—from a new position, one in which viewers are unavoidably enmeshed. 
 
The titular zone, in the 2014 Martin Amis novel that Glazer adapted, is a space that incorporates the Höss residence and the death camp. However, as with his 2013 adaptation of Michel Faber’s Under the Skin (2000), Glazer has reworked the source material into something only tangentially similar. The film, most of which takes place in the Höss house, is viewed in mid and wide shots, and the focus on interpersonal relationships in Amis’s novel is abandoned in favor of a surveillance aesthetic. During filming, Glazer covered the house set with cameras, Big Brother–style, some hidden, some visible in every room. The actors moved around the house, aware they were being filmed but not which cameras were filming them. As a consequence, viewers feel as if they’re watching secretly. While the events taking place in the death camp are obscured from view, the house and garden are subjected contrapuntally to a radical visibility—everything the family does is on show, the very opposite of “ob-skeen,” hyper-visible. 
 
Glazer originally trained in theater design, but despite his stated dislike of films that simply stage drama, theater-like, in front of the viewer, the mise-en-scène of The Zone of Interest insists upon the formal idea of the stage, with Glazer calling the house an “arena.” The film is not stagy; rather, it’s acutely aware of the limits of its frame, and of the tension that derives from our awareness of what lies beyond it. Take the Hösses’ garden, a well-kept area directly next to the death-camp wall. The obsessive planting and cultivation of the space has a sickening counterpart in the unseen ethnic cleansing yards away; an early sequence has Rudolf Höss looking over plans for a circular incineration chamber, whose carefully delineated areas recall visually the garden’s layout. 
 
The Höss house and the death camp participate in a larger dynamic of putative cultivation. The film is well aware, to recall Walter Benjamin, that “[t]here is no document of civilization which is not at the same time a document of barbarism.” But it resorts to a curious formal literalism when delineating its so-called civilized and barbaric spaces, one which becomes bound up with the psychological well-being of the Hösses, and the form of the film itself. When Höss is summoned back to Germany in the second half of the film for possible relocation, we find ourselves transported from a scene of mass murder to the scene where that murder is planned. Despite the acclaim that greets him, Höss appears uncomfortable in Germany, and his wife, Hedwig, who lives unfazed alongside genocide, is distraught at the prospect of leaving her house and garden. The closer Rudolf Höss gets to the original scene of the Holocaust’s conception, the weaker he gets physically. He sees a doctor for an unspecified medical problem; he stumbles around retching; he sits alone in his room. It’s as if the stability of the Hösses is reliant on the scrupulous maintenance of their home in Poland. At times, the form of the film itself can appear on the verge of collapse when its scenic integrity is under threat. As Hedwig Höss tends to her well-kept garden, a shot of a flower—one of the film’s few close-ups—is suffused suddenly with the color red, which obscures the entire screen. The sounds of murder and terror from behind the wall increase, and Mica Levi’s soundtrack judders abruptly in and out, as if coming in on the wrong cue. It’s as if someone has put the film in the wrong gear, and we can hear the grinding of the mechanism as it tries to reassert itself. Sure enough, a few seconds later, the original mis-en-scène abruptly returns. 
 
Glazer’s use of the obscene here occurs within a broader question of what one should or shouldn’t show when depicting this particular historical moment. Concerns about dramatizing the Holocaust on film have regularly come up against at least two objections. Firstly, that no dramatization can do justice to the scale of industrialized mass murder, and secondly, that to use the tools of cinema to dramatize Nazi genocide is to become implicated in the cinematic propaganda that was, of course, a key tool of those who propagated that genocide. Should these films embrace a therapeutic humanism, as Steven Spielberg’s Schindler’s List (1993) does? Should they assiduously avoid the dramatic in favor of spoken testimony, as Claude Lanzmann’s Shoah (1985) does? Juxtapose contemporary documentary footage and wartime images, as with Alain Resnais’s Night and Fog (1955), or more recently Steve McQueen’s Occupied City (2023)? Or go beyond the camp wall, but keep most of the horrors around the protagonist out of focus, as in László Nemes’s Son of Saul (2015)? 
 
Critics of Holocaust films often cite Theodor Adorno’s admonition that to write poetry after Auschwitz is barbaric. But after watching Glazer’s film, I’ve been thinking about his later reconsideration of that statement: 
[I]t may have been wrong to say that after Auschwitz you could no longer write poems. But it is not wrong to raise the less cultural question whether after Auschwitz [one] can go on living—especially whether one who escaped by accident, one who by rights should have been killed, may go on living. His mere survival calls for the coldness, the basic principle of bourgeois subjectivity, without which there could have been no Auschwitz. 
The Zone of Interest adopts this position, specifically Adorno’s alignment of “bourgeois subjectivity” with both the perpetrators of Auschwitz and the position from which one moves on from it, looks back on it, views it. One of the most troubling elements of Glazer’s film is that the viewer is not allowed to withdraw from the film’s radically circumscribed scene. Much of what disturbs us in the film comes from our preexisting knowledge of the Holocaust, with which we fill in the information that takes place out of shot. We can imagine the death camps because we have already seen what happened inside them. But The Zone of Interest follows Adorno’s line further. It makes bourgeois subjectivity, which elides both survivors and perpetrators, the necessary frame from which “we” view the film itself. What a horrible prospect, this indivisible position. And it’s this horror that suffuses so much of the film, the idea that the bourgeois cultivation of the scene, and the unspeakable ob-scene, are somehow inextricable, one the obverse of the other, with the viewer the bloody thread that connects them. 
 
I was struck by this sense of indivisibility during two scenes that take place at night, depicting a young Polish girl, a neighbor of the Hösses, discreetly leaving food for the prisoners by secreting apples in the trenches where they labor during the day. These scenes are shot without lighting and in infrared, so the girl’s body appears as white against the sheer black of her surroundings. It’s a startling, uncanny reversal of the daytime scenes, and the only act of compassion we witness in the film, which must necessarily take place out of sight. It’s hard here not to be reminded of the famous scene in Schindler’s List in which Schindler sees a young child visually distinguished from a crowd of people, her red coat the only color in an otherwise black-and-white scene. We learn nothing about the child as a person, but this is the point. She could be anyone and stands for everyone. In Spielberg’s film, the gesture is fundamentally humanistic. By isolating one individual through the subjectivity of the film’s “hero” as he views the scene, Schindler’s List centers a viewer’s understanding of common humanity, one fulfilled dramatically by a moment of human success: Schindler’s climactic rescue of Jews from the death camps. Aligned with Schindler’s vision, viewers ally themselves with humanist action: I view like him, and I would do as he does. With The Zone of Interest, we’re not permitted this position. As the illuminated girl plants apples equal distances apart in the dirt, we realize what we’re viewing is an inversion of the planting of Hedwig’s garden. One scene is the twin of the other. The implication in these matched, intertwined gestures—that good and evil are qualities of which any human is, in the right circumstances, capable—is considerably more discomfiting than Spielberg’s assumption of the viewer’s separation from the atrocities taking place on-screen. 
 
These night sequences are made more discordant by the soundtrack that plays under them. The film has no music other than at the opening and closing credits, but during these infrared scenes, the action is accompanied by a loud guttural sound, almost like a belch but deeper and less identifiably human. Watching these scenes, I felt as if I was hearing some vast repressed thing erupting, pushing up and out and into the world of the film. It’s a deliberately incongruous noise, clearly not coming from anything on-screen. It’s messy and untidy; it’s at odds with the scrupulousness of the mise-en-scène, and it appears when things oppose or undercut Höss’s vision. Later, these noises, which initially accompany only the night-vision scenes, increase in frequency and recur when a clearly uncomfortable Höss is in Germany. He’s examined by a doctor, and their dialogue suggests that his problem is digestive, that something is not breaking down properly, is threatening to explode out of Höss’s body. It feels as if the film is moving not toward resolution but cataclysm, eruption, and breakdown. 
 
Sure enough, in the final sequence of Zone, this tension cracks the film open. Höss, drunk and stumbling out of a party, walks down a stairwell. When he reaches a landing, he starts to physically retch, but doesn’t vomit. He walks down another set of stairs to an identical landing, and dry-retches again. He looks down the corridor and sees a tiny point of light in the darkness. A door opens, flooding the room with light; we’re in Auschwitz, 2023. For 10 minutes, we see workers entering and cleaning the museum that now stands on the site of the camp. The effect is startling, uncanny. That tiny point of light is a portal through which we see the future, a scene out of time. This breakdown of time and space is the eruption that’s been coming, and for the first time, we find ourselves on the other side of the camp wall. We view this scene through a different mode: documentary. The sequences in the museum play out in long fixed takes. We see the ovens being cleaned, the gas chambers being swept, piles of clothes and shoes from dead prisoners, and a corridor lined with photographs of those murdered in the camps. What has been concealed from us, the ob-scene, is now visible. The cleaning and cultivation of the Auschwitz-Birkenau State Museum creates a new scene, one of remembrance and testimony, in which the lives of those millions murdered are brought into sight. 
 
Is this abrupt shift to documentary an admission of the failure of Zone’s dramatic form? No, because the juxtaposition is the point, and in these final moments Glazer opens and extends the scene of Zone to something larger: the visual representation of other historical scenes of mass murder (“It’s about now,” he said of the film in a recent interview at the British Film Institute). This climactic breakdown recalls the endings of two recent films, Ari Folman’s Waltz with Bashir (2008) and Joshua Oppenheimer’s The Act of Killing (2012), in which a final change of viewing position, a bringing-into-view of something previously unseen, is revelatory to an understanding of an atrocity. Folman’s animated film ends with the simultaneous realization by Folman of his complicity in the Sabra and Shatila massacre in Lebanon, and the removal of the film’s animation filter to show real, uncensored footage of the killing. Oppenheimer’s film ends with war criminal Anwar Congo watching a reenactment of tortures he himself carried out, only now he plays the torture victim. Viewing, Congo appears to undergo a moment of realization, and—exactly like Höss in Glazer’s film—repeatedly retches but is unable to vomit. In these formal shifts, these films acknowledge that the obscenity of the act of mass killing can only be fully rendered through a hybridized way of seeing, one in which the documentary form catalyzes a clarity of vision. What’s unsettling about the end of Glazer’s film, though, is the continuation of that entwining of those preceding acts of cultivation, of staging and scene creation, from atrocity to act of kindness to memorial. The viewer isn’t allowed to step outside of this entanglement. Instead, the film asks, against the abominations of the contemporary world, what do we bring into view and what do we push out of sight? What scene would we make? What scene are we making right now? 
 
But The Zone of Interest doesn’t end there. Instead, it cuts back to Höss, staring down the corridor toward the camera, before he turns and walks down the stairwell into total darkness. It’s impossible to read Höss’s reaction—whether he sees and doesn’t care, or whether he attains some understanding of his actions, of what has erupted into his vision. Ultimately, though, what we witness is Höss leaving the scene. His disappearance into darkness prefigures his infamy and execution, while the lives of his victims are illuminated with ever more clarity. And we watch, implicated. The credits roll, over darkness.

Viewing the Ob-scene: On Jonathan Glazer’s “The Zone of Interest”

Dr. Uché Blackstock is a physician and thought leader on bias and racism in healthcare.

Uché Blackstock

Legacy: A Black Physician Reckons with Racism in Medicine

Constance B. Hilliard is a professor of history at the University of North Texas. She is the author of several books, including Straightening the Bell Curve: How Stereotypes About Black Masculinity Drive Research on Race and Intelligence (2012).

Constance B. Hilliard

Ancestral Genomics: African American Health in the Age of Precision Medicine

Naa Oyo A. Kwate is an interdisciplinary scholar and writer whose latest book is White Burgers, Black Cash: Fast Food from Black Exclusion to Exploitation (2023).

Naa Oyo A. Kwate

BILLY WOODBERRY’S BLESS Their Little Hearts (1984), written and filmed by Charles Burnett of Killer of Sheep (1978), follows a Black family living in Los Angeles. The husband, Charlie (Nate Hardman), has been unemployed for 10 years, and during that time, his wife, Andais (Kaycee Moore), has been carrying the couple and their three children. In one scene, Charlie works as a day laborer, scything down a hilly tangle of weeds. Once he’s finished, he climbs aboard the rickety pickup truck of the man who hired him and they drive down South Central Avenue, rolling past block after block of rubble, hollowed-out buildings, naked steel girders, and concrete lots reverting to grassland. Charlie takes in the grim scene while smoking. He is bearing witness to the demise of the Goodyear Tire &amp; Rubber Company’s 74-acre site, which employed nearly 600 people until it closed in 1977. The flight of hundreds of thousands of industry jobs represented by Goodyear’s dissolution was a crushing blow to the social and economic life of Black Los Angeles. The ravages of their neighborhood are reflected in Charlie’s and Andais’s personal lives. The erosion of social structures has intimate consequences, as cultural critic <a href="https://us.macmillan.com/books/9781250112576/eloquentrage">Brittney Cooper</a> has described. When Andais explodes in anguish and frustration at Charlie’s failure to provide (on top of his ongoing affair), time’s cruelties are laid bare. Andais is bone-tired. 
 
The problem of being Black in the United States is, in part, one of time. In Between the World and Me (2015), Ta-Nehisi Coates puts it well: “[P]erhaps the defining feature of being drafted into the black race was the inescapable robbery of time, because the moments we spent readying the mask, or readying ourselves to accept half as much, could not be recovered.” Whenever sundown towns come up in public discourse—which happens with surprising frequency—I think about how they represent an extreme robbery of time: Black people could not exist publicly for the duration of a full day. Sundown municipalities decreed that Black persons appearing on city streets after sundown could be arrested, violently expelled, or murdered. In Marlow, Oklahoma (today 0.16 percent Black), a porter named Robert Johnigan was shot by a white man in 1923 after a gathering mob threatened to lynch him for defying, as The Rock Island Argus reported, “a rule which forbids negroes to stay after sundown […] Marlow’s unwritten law, exemplified by public signs commands: ‘Negro, don’t let the sun go down on you here!’” Sundown towns may represent extreme cases, but they serve to illustrate the more mundane robbery of time at play in routine Black life, and the additional layer of friction that stops Black folks from living well, or fully. 
 
Dr. Uché Blackstock’s new memoir Legacy: A Black Physician Reckons with Racism in Medicine melds her own story with an incisive analysis of why Black people in the United States are disproportionately sick and die early. The book is an homage to her mother, a Black woman and physician in whose footsteps she (and her twin sister Oni) followed, and a compelling insider perspective from a doctor who has worked in various New York City health institutions. The kind of time deficits and distortions that haunt Black life appear early and often in Legacy’s pages. 
 
Blackstock’s mother, Dr. Dale Gloria Blackstock, was an attending physician who specialized in nephrology at Kings County Hospital Center in Brooklyn. She had grown up in poverty, lacking access to routine medical care, and was taught by Catholic school nuns who laughed outright at her professional ambitions. The first in her family to obtain a college degree, she then went on to graduate from Harvard Medical School in 1976. She and her husband Earl Llewellyn, an immigrant from rural Clarendon, Jamaica, raised the two girls in Crown Heights in the 1980s and ’90s. Dale Blackstock died from acute myelogenous leukemia at the devastatingly young age of 47, leaving behind two bereft daughters halfway through their undergraduate studies at Harvard, and a legacy of Black women mentees who now occupy leadership positions in medicine. 
 
As a child, when Uché Blackstock and her family had to travel to predominantly white spaces in the city like Park Slope in order to obtain fresh produce, and when she was exposed to classmates’ environments—clean, fecund, expensive—she realized that “a good life was available to us, just not where we lived, nor among people who looked like us,” nor, I would add, without additional expenditures of time. The house they grew up in was “a wreck” that consumed her father’s time for a decade after purchase; the rest of the block was tottering towards ruin. Both trajectories were products of redlining policies, which wasted time—creating more friction in Black lives and more opportunities for failure. During Blackstock’s youth, crack infiltrated Crown Heights. Here the state’s lack of investment of time in quality education, jobs, and social opportunities came home to roost in an epidemic that devastated families and communities across New York City and the country. The epidemic garnered the only thing for which the United States has a surfeit of time when it comes to Black folks—policing. 
 
A visceral, harrowing incident in which Blackstock nearly ran out of time occurred during her first year of medical school, when she had a near-death experience over an inflamed, and then burst, appendix. In a diagnostic scenario in which time was utterly of the essence, residents wasted it by offering causes for her symptoms that failed to see Blackstock as an individual but rather as their stereotyped notion of a Black woman. The attending physician ruled out the possibility of appendicitis, saying that Blackstock “didn’t seem to be in that much pain.” And then he left. By the time all was said and done, Blackstock had cheated death, survived two surgeries, and missed five weeks of medical school for something that most people recover from in a few days. As she ponders how biases clouded her treatment, she muses on Toni Morrison’s dictum about the distraction of racism, and the fact that “you waste hours of your life trying to figure it out.” 
 
Blackstock’s patients were themselves aware that, as Black persons seeking care, time was not on their side. At the beginning of the COVID-19 pandemic, Blackstock was a practicing physician in a Brooklyn urgent care clinic. Donning full head-to-toe personal protective equipment (PPE) that obscured her physical features, she greeted a young Black woman. The patient tentatively responded, “Can I ask you something? […] Are you Black?” When Blackstock affirmed that she was, the woman sighed with relief and said, “At least I know you’ll listen to me.” Physicians routinely fail to allot the requisite time in encounters with Black women. We know the stories: Serena Williams had to diagnose her own blood clot; Susan Moore, herself a physician, was treated with contempt and dismissed by a white physician, because of which she died of COVID-19 at the age 52. Racialized time in medical care casts asunder protocol, empathy, and common sense. 
 
As an academic, Blackstock encountered racism that will provoke shudders of recognition among Black women in many professional settings. At New York University’s medical school, patients doubted her expertise or credentials, seemingly incredulous that she was the doctor. It got worse over time: 
 
Ever since Trump’s election in 2016, there had been a marked uptick in explicitly racist incidents within hospitals. Whereas in the past the racism we encountered from patients tended to be more covert, now they felt emboldened, asking outright, for example, to be treated by white physicians. 
The patients, like the country, were backstroking to the freer, full-bodied buoyancy of racism of times past. A time when Black people had much shorter lifespans. A time very much like … now. Contemporary childbirth statistics smirk at figures from the early 20th century. In 1915 (the year The Birth of a Nation was released), “Black birthing people were almost twice as likely to die from pregnancy-related complications as their white peers.” Blackstock tells us that today the ratio has climbed to three to four times more likely. These glaring inequities radicalized her. She saw them disrupting lives time and again. One mother missed follow-up appointments for new onset kidney failure because her kids were sick—and she would have to wait another six months for the next available appointment. Blackstock explains, “Once I began to see the failures of our health-care system to take care of Black people, I couldn’t stop seeing them. There were examples everywhere.” Legacy is a searing indictment of those failures. 
 
Meanwhile, Blackstock’s description of typical medical training suggests that the profession is stuck in a time machine. The proportion of Black to non-Black physicians has not changed much from what it was 100 years ago: “In 1910, 2.5 percent of all US physicians were Black. By 2008, that number had increased to 6.8 percent.” Eager students continue to endorse racist tropes about Black people’s bodies, including early 19th-century ideas that Black people have thicker skin and are less susceptible to pain. Blackstock recounts: 
 
Throughout our medical school education, we learned that there were different standards of normal for different patients […] When diagnosing kidney dysfunction, for example, we were taught that Black patients had higher normal kidney function than non-Black patients, based on the racist presumption that Black people have a higher amount of muscle mass. Much later in my career I learned that this particular race-based testing has horrifically led to kidney function being underestimated in Black patients, leaving them less likely to receive the specialty kidney care they need or being excluded from the kidney transplant waitlist because their kidney function may appear normal. 
In Ancestral Genomics: African American Health in the Age of Precision Medicine (2024), evolutionary historian Constance B. Hilliard also considers kidney function. This book is not a memoir, although a medical encounter serves as its point of departure. While traveling in Japan, Hilliard was startled when a doctor diagnosed her with advanced kidney failure. When she returned home, her primary care physician rejected the diagnosis and explained that her lab results revealed perfectly healthy kidneys. The problem was that the Japanese doctor had not applied a race correction that scales African American renal function differently. This bizarre state of affairs sent Hilliard on a quest to understand how and why race, the social construct that it is, could insert itself into medical care and constitute the axis around which a diagnosis of renal failure could turn. Where Legacy critiques the racist tropes that undergird medicine’s normative metrics, Ancestral Genomics looks back in time, seeking to recover a historical understanding of misinformed care. Alas, it offers a theory that has been repeatedly debunked. Hilliard argues that the problem is fallaciously assuming that two people who identify as Black share something called “race” that would make their kidneys operate similarly. Instead, these two hypothetical people “would have dramatically different kidney readings if one hailed from the salt-rich coast and the other was genetically adapted to the sodium-deficient interior of the African continent.” 
 
With this claim, the unfortunate focus of the book comes into view—to reanimate a variation of the “slavery hypothesis,” which holds that Black people today are prone to hypertension because their centuries-old African heritage comes with an abnormal physiological regulation of salt. One version of the hypothesis holds that the African persons who underwent the Middle Passage excreted excessive amounts of salt in sweat, waste excretions, and vomit, and those who survived passed down a genetic propensity to retain salt, which, the theory says, was beneficial for surviving the hold but damaging to descendants living on land. Another version, which is what Hilliard offers, contends that the African people who were taken captive from “sodium-deficient” lands bore descendants ill-equipped to live in the salt-laden society of contemporary America. I couldn’t help but wonder what nephrologist Dale Blackstock would make of this theory. 
 
When African Americans face relentlessly constrained access to what sociologists including Bruce Link and Jo Phelan <a href="https://pubmed.ncbi.nlm.nih.gov/18418986/">define</a> as the flexible resources that fundamentally drive health—“money, power, prestige, and beneficial social connections”—a genetic explanation for racial chasms in life and death is unlikely to be persuasive. To understand why, consider that between 2016 and 2020, the rate of new lung cancers among Black men was 11 percent higher than in white men. One need only look to risk factors like aggressive menthol cigarette marketing, which has blanketed Black communities for decades. Over the past 40 years, approximately 40 percent of the excess deaths attributable to menthol cigarette smoking <a href="https://www.cdc.gov/tobacco/basic_information/menthol/related-health-disparities.html">landed among</a> African Americans. Black men are not disproportionately stricken with lung cancer because their genes are different from men categorized as white. The Biden administration is, as I write this, <a href="https://www.washingtonpost.com/health/2023/12/05/menthol-ban-delayed-biden-administration/">considering a further delay</a> to an already postponed ban on menthol cigarettes, fearful that it will hurt his reelection campaign. It is taking the ghoulish gambit that Black votes are more pressing than excess Black sickness, suffering, and premature death. It’s a calculus that sounds like it came from the computerized voice activated when pedestrians push the beg button at a crosswalk: “Wait. It’s not a good time.” 
 
The crux of the argument in Ancestral Genomics rests on the notion that African Americans descend from farmers who lived in “stateless societies” in the “West African interior,” occupying lands too far from the coast to reliably access sea salt. The lands, according to Hilliard, 
 
were perceived as worthless even by the standards of their African neighbors (because this geographic region lacked even the most minimal deposits of sodium that most humans need to survive). […] Its inhabitants had subsisted on 200 milligrams (mg.) of sodium a day while coastal West Africans, Europeans, and later Americans consumed between 3,400 and 5,000 mg. of sodium a day. 
No scholarship is cited to support these assertions, and researchers have pointed out that any society close enough to the coast for its members to be abducted into slavery is close enough to have access to sea salt. African Americans have physically embodied history, but it’s not the history of salt. It is labor history, and the history of housing, education, voting rights, and criminal justice. Black health directly reflects the history of racism in the United States, which is why the political Right doesn’t want that history taught. As scholar Elizabeth Alexander has asserted, “If any one aphorism can characterize the experience of black people in this country, it might be that the white-authored national narrative deliberately contradicts the histories our bodies know.” 
 
Hilliard rejects the essentializing of race that underwrites the renal correction, but then turns to genetics in an equally essentializing way, taking as a given that Black people have a “hypersensitivity to sodium.” Oddly, in an effort to refute racial essentialism, the text recounts 19th-century craniometry research—which invariably found that people from Africa had underdeveloped skulls—but not to say that the whole thing was malarkey. Rather, Hilliard asserts that “[w]e now know that the African continent, because of its greater genetic diversity, boasts skulls of all shapes and sizes.” I can imagine that someone like phrenology enthusiast Dr. James Mortimer from The Hound of the Baskervilles (1902) might be impressed (he effused to Sherlock Holmes, “A cast of your skull, sir, until the original is available, would be an ornament to any anthropological museum. It is not my intention to be fulsome, but I confess that I covet your skull”). 
 
Hilliard contends that the pendulum in medical literature has swung inappropriately to a “colorblind” approach that fails to consider how population-specific gene variants trigger disease. She defines “Ecological Niche Populations” as groups that “shared a similar health disparity triggered by the same adaptive gene variant.” To be sure, the shorter, sicker lives of African Americans as a population is not, in her view, because of “race.” But neither is it because of gene variants. It’s because of racism. Hilliard suggests that there is disproportionate time and money spent on investigating stress and inequality as causes of hypertension, and hints that the harder-hitting promise of genetic hypotheses on salt have been left by the wayside in favor of sexier theories about racism. The reality is that the National Institutes of Health are deeply invested in explaining and addressing health through processes that go deeper and deeper into the body, rather than outside the body to social structures. Consider cancer, which prematurely took the lives of both Blackstock’s and Hilliard’s mothers (for the latter, breast cancer at age 51). Over the past 10 years, the NIH’s National Cancer Institute has funded three studies on the health effects of racism. But for projects on genes and cancer, they supported 6,080—6,080 versus three. 
 
Together, Legacy and Ancestral Genomics demonstrate how badly the nation’s health institutions need reworking from the ground up. Black people don’t have time to wait for medicine or biomedical research to commit to undoing excess deaths, because time is not money but life. That’s why when Dale Blackstock was nearing death, she instructed her daughters to care for themselves by taking time off before medical school. That’s why we find resistance to racialized time and time loss. Curator Meg Onli’s 2019 exhibition <a href="https://icaphila.org/exhibitions/colored-people-time-mundane-futures-quotidian-pasts-and-banal-presents/">Colored People Time</a> interrogated a “collective performance of refusal: A refusal to disavow our embodied sense of time, beyond capital’s demands. […] A refusal to adhere to Western time as the only time.” Away with oppressive time signatures. Away, timeless racism. Away, time’s tally lost. Black life on its own time.

“Kudos” by Rachel Cusk

June 18, 2018

Did you know LARB is a reader-supported nonprofit?