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The Two Kinds of Decay: A Memoir Paperback – May 26, 2009

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Editorial Reviews

From Publishers Weekly

Starred Review. In 1995, when Rome Prize–winning poet and fiction writer Manguso (Siste Viator) was a junior at Harvard, she suffered the first attack of a rare autoimmune disease called CIDP, which would turn her body against itself. CIDP attacks the myelin coating of the peripheral nerves. The result is increasing numbness, followed by paralysis spreading from the extremities inward, until the sufferer can no longer control his or her breathing, and dies. In short, lyrical chapters—the book free-associates between memories, while sticking to a rough chronological order—Manguso recounts the harrowing indignities of her treatments, frequent relapses, descents into steroid-induced clinical depression, crucial college sexual experiences had and missed, and trips back and forth between schools, hospitals and her parents' Massachusetts home. What makes this lightning-quick book extraordinary is not just Manguso's deadpan delivery of often unthinkable details, nor her poet's struggle with the damaging metaphors of disease, but the compassion she acquires as she comes to understand her pain in relation to the pain of others: suffering, however much and whatever type, shrinks or swells to fit the shape and size of a life. (June)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to an out of print or unavailable edition of this title.


“Manguso has produced a remarkable, clear-eyed account that turns horror into something humane and beautiful.” ―The New York Times Book Review

“Moving . . . a fiercely truthful memoir of illness.” ―The Boston Globe

“Here is not a day-by-day description of this grueling time, but an impressionistic text filled with bright, poetic flashes. . . . Many sick people learn to live in the moment, but the power of Manguso's writing makes that truism revelatory.” ―The Washington Post Book World

“Manguso's slender volume is written in a sparese, no-nonsense style that can be chilling but makes you cheer for the author.” ―New York Post

“Manguso writes this account from the far end of the illness, looking back on it from a position of physical strength, biting ferocity, and unsentimental wit.” ―Bookforum

“A series of brief, elliptical vignettes composed of sentences as spare as they are unsparing . . . Manguso pushes beyond the familiar confrontation between doctor and patient to explore the linguistic confusion at the heart of the power struggle.” ―Slate

“[A] stunning story . . . Manguso's deadpan tone works equally well in service of the painful and funny moments, or when the two meet.” ―Time Out Chicago


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Product Details

  • Paperback: 192 pages
  • Publisher: Picador; 1st edition (May 26, 2009)
  • Language: English
  • ISBN-10: 0312428448
  • ISBN-13: 978-0312428440
  • Product Dimensions: 5.5 x 0.4 x 8.5 inches
  • Shipping Weight: 10.6 ounces (View shipping rates and policies)
  • Average Customer Review: 4.3 out of 5 stars  See all reviews (28 customer reviews)
  • Amazon Best Sellers Rank: #50,635 in Books (See Top 100 in Books)

More About the Author

Sarah Manguso is the author, most recently, of Ongoingness: The End of a Diary. Her five other books include The Guardians, named one of the top ten books of the year by Salon, and The Two Kinds of Decay, named an Editors' Choice by the New York Times Book Review and a Best Book of the Year by the Independent, the San Francisco Chronicle, and the Telegraph. Her other books include the story collection Hard to Admit and Harder to Escape, included in in McSweeney's One Hundred and Forty-Five Stories in a Small Box, and the poetry collections Siste Viator and The Captain Lands in Paradise, which was named a Favorite Book of the Year by the Village Voice. She is the recipient of a Guggenheim Fellowship and the Rome Prize, and her books have been translated into five languages. Her essays have appeared in Harper's, the New York Review of Books, and the New York Times Magazine, and her poems have won a Pushcart Prize and appeared in four editions of the Best American Poetry series. She grew up near Boston and now lives in the San Francisco Bay Area.

Customer Reviews

Most Helpful Customer Reviews

19 of 20 people found the following review helpful By C. Hutton on June 21, 2008
Format: Hardcover
Ms. Manguso has written a medically graphic but affecting account of her battle with an auto-immune disease. Written in brief paragraphs with short chapters, the author is clealy recalling a bad dream that she rather not recall. A poet, her writing is lyrical and conversational. Once the reader starts her story, you will not put it down and it is easily read in one sitting. But it is a book that you will come back to.
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10 of 11 people found the following review helpful By Julee Rudolf VINE VOICE on September 13, 2008
Format: Hardcover Verified Purchase
Sarah Manguso, afflicted at age twenty-one (in 1995) with a Guillain-Barre-like syndrome called CIDP, wrote The Two Kinds of Decay after seven years of remission from her illness. (p 2) "For seven years I tried not to remember much because there was too much to remember, and I didn't want to fall any further behind with the events in my life." Of the disease, the reader learns (p 19) "The condition may resolve spontaneously, relapse and remiss indefinitely, or progress and terminate in death." Talk about an uncertain future. In this succinct, simply-written story of a life, Ms. Manguso tells all: of her initial symptoms (numbness in her feet); treatment (and mis) including hours spent undergoing apheresis (p 10) "the process of separating blood into its components" and the painful procedure of having a permanent line surgically implanted in her chest (the apparatus shown on the cover); interactions with hospital staff, friends, family and complete strangers; the effects of the various treatments on her body; and just plain living with a rare, rotten, debilitating condition. Of a doctor, who tries to quantify her high level of suffering, she writes (p 83, 84) "he didn't understand yet that suffering, however much and whatever type, shrinks or swells to fit the size and shape of a life." Near the end of the book she shares (p 171) "Having spent my twenties expecting to die, I turned thirty and arrived in the afterlife with nothing left to do." She's done a lot since then, notably: running, writing, living and loving. She ends with a line explaining the title (I won't spoil it) and shares what she learned from years of agony, (p 183) "This is suffering's lesson: pay attention." The nine sentences that follow are equally excellent. Also good: Lucky Man by Michael J. Fox, Mountain Beyond Mountains by Tracy Kidder and There is No Me Without You by Melissa Fay Greene.
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7 of 7 people found the following review helpful By Charli M. Henley on April 10, 2010
Format: Paperback Verified Purchase
This is an unsentimental and unapologetic memoir of illness. The poetry here left me breathless. The disease Manguso describes is a terrible one, but she weathers it gracefully.

The time line is not a linear one - events in the book take place as if they are just foggy memories and not a plotted story - a realistic and satisfying take on the memoir narrative.

Every word is carefully placed, like an IV or a scalpel. Manguso is a surgeon-poet, wasting nothing. Very precise, very beautiful, very painful.

I've read this book twice now. It was recommended to me by a stranger at a party when I revealed my own recent diagnosis of kidney failure and an autoimmune disease. The book makes me feel hopeful - if she could do it, I can do it. It makes me feel courageous. It offers solidarity in the way few others can - without pity, without tears, without fear. And yet, the book makes me cry.

The story of an illness could be trite. Manguso avoids cliche and does not tell us she has learned to be a better person, that she has found God, or even that she is bitter. She tells us simply that illness forces one to live in and for the moment. While she doesn't herald this epiphany as a triumph, I certainly do.
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7 of 7 people found the following review helpful By Michael Chapman on July 6, 2008
Format: Hardcover
This book is a compelling read. It's a testimony to one woman's resiliance when the terrible thing happens to her, not to some stranger.

Manguso has the courage to revisit her devastating illness, and the wisdom to find the ironies, the lessons, and even the humor in her experience.

Through her sharing of the story of those terrifying sick years, she lets us see the indomitable spirit and the sense of humor that enabled her to survive them and heal.

She juxtaposes pictures of illness against the lyrical beauty of her writing. I find new treasures whenever I reread it.
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8 of 9 people found the following review helpful By SP NYC on July 16, 2008
Format: Hardcover Verified Purchase
This is a short book about Sarah Manguso's experience with a strange autoimmune illness, which began suddenly during her freshman year at Harvard. You could easily read it in an afternoon, but it might take longer since there are so many beautiful passages to go back and read again.

She has said that she intentionally did not write about the disease after it began; it must have been too difficult. In reading this book, I got the impression that as she wrote, she was actively rediscovering and redefining her illness and what her life became in the wake of being sick.

Ms. Manguso is an award-winning poet, and the fantastic writing alone is worth the price of admission. The chapters are often only a page or two, the paragraphs only a few lines. The writing is simple and insightful--whether she is discussing a mundane detail, humiliating experience, or a scientific technicality. She is capable of being heartbreaking in one sentence and uplifting in the next.

I should admit that I am a medical student (final year), so perhaps I got a double benefit. Her description of illness is fantastic. If I had learned about this disease from a textbook, it would have been just one of hundreds of cold facts in my brain. But from her description, I began to imagine a mysterious illness that went beyond mere words. I am sure that I now have a better understanding of patients with long-term disease. Moreover, for anyone who has to deal with illness, Sarah Manguso has likely put into words some of the complicated, frustrating feelings that accompany repeat trips to the doctor and hospital.
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