Thomas Larson’s Heart and Soul

January 15, 2014 § 4 Comments

A Guest Book Review From Richard Gilbert

As long as humans feel threatened and helpless, they will seek the sanctuary that illness provides.”—Dr. Robert R. Rynearson

larsonOne evening, as he teaches his Monday night memoir class in San Diego, Thomas Larson, age 56, feels his throat burn with acid. He’s sweaty, breathless, confused. In rising panic he flees to a bathroom, then dismisses his students and races to an emergency room. Prepping him for the angioplasty and stenting that will open two blocked arteries and save his life, a nurse peels off his clothes: “They’ve been stuck on me like a soiled diaper for half-an-hour. My body is leaking its insides. It’s not the soul coming out, wet and furious. It’s my skin, like packaging, trying to strip itself of the invader.”

Larson, author of The Memoir and The Memoirist: Reading and Writing Personal Narrative and The Saddest Music Ever Written: The Story of Samuel Barber’s “Adagio for Strings,” depicted this March 2006 attack in a Brevity essay, “One Way It Happens.” His new book, The Sanctuary of Illness: A Memoir of Heart Disease (Hudson Whitman, January 15, 2014), relates his experience of three heart attacks and their aftermath. Though it spans six years, the book is stunningly concise, 128 pages.

Half a million Americans die from heart disease a year, one-third under age 65, Larson tells us, four in five felled without any foreshadowing pain, dead as quick as 51-year-old James Gandolfini on the bathroom floor of his hotel, and “swoosh—it’s time to update the Wikipedia page.” Dire statistics are one thing, but living through Larson’s ordeal is jolting. Here he riffs, having arrived for his first post-infarct stress test:

Right off, the waiting room strikes me—purgatory’s nursery. On the tight-weave chairs a dozen of us heart patients sit, mid-afternoon. . . . In the ward from which the attendant will come, I imagine the smell of catheters, tubes stuck in flesh, the caustic stink of a draining infection under the scrub-brush sparkle of this cardiology wing, computers on wheeled platforms, the weight scales, the boxes of purple gloves, the plastic holders where my file goes on the outside of the door so Dr. J can, in seconds, scan the chart of whichever room, like rowed animal cages in a zoo, he enters.

Larson’s season in hell has just begun. Genetics partly explains it, his father dead at age 61 from a massive infarction; his older brother, morbidly obese, dead of the same at 42. Larson had been a vegetarian for 25 years, so was trying. But he was middle-aged busy and had become obese himself on a diet rich in cheese and eggs. And even his veggie dishes contained artery-clogging oils.

The Sanctuary of Illness is structured in four equal parts, as balanced and sturdy as our own four-chambered hearts. Within Larson’s dramatic foreground narrative, jump-cutting forward or patiently retracing, he grapples with himself, heart and soul. Amidst his despair over his damaged pump, he confronts baggage: his upbringing, his first, unhappy marriage, the weight of his illness on his relationship with his partner, Suzanna. Slowly he takes control of his health; slowly he sees that his heart crisis happened not just to him but to Suzanna as well. He admits herfear, sees her being forced into a caretaker’s role, imagines her likely early widowhood. He recalls his depressed mother, marooned by male cardiac failure.

In compassion and in love for Suzanna, Larson grows, with great effort, beyond his genetics and history. Beyond the refuge of machismo that tells him to suck it up and die—alone. “The sharing,” he writes, “of what is ultimately not mine but ours creates the sanctuary.” In a book rich in metaphors, this redemptive repurposing of another’s bleak metaphor delights.

Living on the brink of death for six years informs and provokes Larson’s writing; as his journaling grows into the memoir you’re holding in your hands, you glimpse a heartening synergy. “No wonder I love the form,” he writes. “It has my back. The story, ever unfinished, will take me where I would not have gone without it.” Indeed, The Sanctuary of Illness—a model of the memoirist’s art—also feels like an instrument of personal discovery and healing. And it meets the test Larson posits in The Memoir and The Memoirist: self-disclosure rather than event sequence is memoir’s reason for being. Intimate, searching, vivid, Larson’s story is also a cautionary tale that if heeded might prolong your life.


Richard Gilbert’s interview with Thomas Larson about writing memoir, heart disease, and a healthy diet appears on Gilbert’s Draft No. 4 blog. The author of Shepherd: A Memoir (Michigan State, May 1, 2014), Gilbert’s essays have appeared in many journals, including “Kathy” in Brevity.

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