Editor’s Note: We are delighted to publish, in bilingual edition, the winning essay of our second annual Literary Essay Contest: “Imperceptible Anatomies” by Mexican writer and academic Guillermo Jesús Fajardo Sotelo. The prize jury had this to say about the essay:
“Imperceptible Anatomies,” by Mexican writer and academic Guillermo Jesús Fajardo Sotelo, is an essay that, from the trigger of a genetic condition, elaborates a penetrating discourse on personal health, the dimensions of an exceedingly rare pathology, and its links to literary creativity. This is an essay that shows extraordinary balance between the confessional, intellectual inquiry, the clinical aspect, and literary reference points. It likewise represents a minor epic on life and the questions surrounding the demands of the human body—a body, as Fajardo Sotelo calls it himself, that is “anatomically disobedient.”
Yes, my heart beats on the right side of my body. I was born with a rare genetic condition called situs inversus totalis, which means all my organs coexist, as if in some motley neighborhood, on the opposite side from where they should be. Among the medical terms that classify me as a rarity, I have—our defects are also ours—dextrocardia and a heart murmur, since one of my valves doesn’t work as it should: the tricuspid, to be precise. I have never demanded an explanation, from nature or from medicine: the former would show me an unsayable concert of inexplicable phenomena, and the second would tell me it was caused by a mutation in the genes “ANKS3, NME7, NODAL, CCDC11, WDR16, MMP21, PKD1L1, and DNAH9,” and both parents contributed to the condition.
Despite this curious pathology, my body functions normally, perhaps by a miracle. A few years ago, though, something happened to me that I now call The Event; something that, to date, none of my cardiologists has been able to explain. One night, I woke up from sleep feeling overheated and intensely dizzy. Confused, I realized my heart was beating furiously, as if it wanted to explode, as if it was reprimanding me—for the first time—for its position in my body, the strangeness of its being displaced to an unnatural, anatomically incorrect geography. As best I could, I made it to the door and alerted Erin, my wife, who managed to calm me down. We didn’t have to call 911: just as it started, it ended. Siri Hustvedt, in her book The Shaking Woman or a History of My Nerves (Picador, 2010), tells how, while speaking in public on the death of her father, she started shaking uncontrollably. “My knees knocked. I shook as if I were having a seizure. Weirdly, my voice wasn’t affected. It didn’t change at all.” This moment drove Hustvedt to write about her experience, in an effort to understand what happened that day.
I believe this effort of mine, however minimal and superficial it may be, is born of a similar drive.
***
A few years ago, before I decided to go study literature in the United States, I joined an essay-writing workshop in Mexico City. That was when, for the first time, I knew I wanted to write about my anatomically disobedient body, although I did so in the third person. However, after reading Jorge Volpi’s Examen de mi padre (Alfaguara, 2016), I was overcome by the need to confess this apparent oddity that, nonetheless, can be neither seen nor felt. Much like Hustvedt with her shaking fits, I too was unaware—I still am—of what happened to me that night, during The Event. Could my body have reacted to an inexplicable nightmare in my sleep? Could it have been a premonition of what awaits me in the future? Could I have been sleeping in the wrong position? I made an appointment at the Cardiology Division of the University of Minnesota, where I was working on my doctorate. I asked the cardiologist if it had been a heart attack. “No. A heart attack doesn’t just go away,” she told me. They gave me fitness tests, they created a whole map of my body, they prescribed me beta blockers, but the explanation for what had happened to me that night was still wrapped in mystery.
***
This is how Chavoret Jaruboon tells it in The Last Executioner (Maverick House, 2011), his memoirs as an executioner for the government of Thailand. Jaruboon describes how a woman, Ginggaew Lorsoungnern, along with six other people, decided to kidnap the six-year-old son of their former employers. Lorsoungnern herself picked up the child after school and drove him to their hideout, where he would be held until his family handed over the money. After kidnapping him, they decided to murder him, since his parents couldn’t find the exact spot where they were meant to turn in the ransom. Lorsoungnern’s accomplices stabbed him and buried him alive. The Thai authorities soon found them and sentenced three of the conspirators to death, including Lorsoungnern. On the morning of January 13, 1979, Lorsoungnern was placed before a firing squad. She fainted several times, begging for mercy. They tied her up to keep her still and, with a white screen, indicated the exact location of her heart. Ten bullets passed through her body. The attending doctor declared her legally dead. She was transported to the morgue and, while the second death sentence was executed, Lorsoungnern woke up. Desperate screams came from the morgue. Soon, the authorities realized Lorsoungnern was still breathing. This time she begged not for mercy but for death. She was tied, again, before the firing squad. Fifteen shots were fired from an HK MO5 submachine gun. Only then did she perish.
Afterwards, it was discovered that Lorsoungnern did not die the first time because her heart was on the right side.
Like mine.
***
Like Jorge Volpi, I grew up surrounded by doctors. Maybe that’s why I wondered, for much of my youth, if I should study medicine. The answer to the question of this lost calling came one December day during winter break, many years ago, when my uncle invited me to observe a minor operation he was going to perform on my mother, to remove a mole on her face. All I remember is a dizzying trickle of blood running down my mother’s cheek and the rushed, swelling cotton swab that absorbed it. Watching that made me feel terribly faint. At that moment, I was sure of two things: I would never be a doctor, but I would admire them forever. My favorites are internists, who seem to me the closest to the art of literature, since they formulate a narrative based on symptoms the patient describes to them, creating a story—which is to say, a diagnosis. Back to Volpi: “We live in a ‘heartless’ age. In its obsession with defending business interests from the demon of the state, neoliberalism has sought to eliminate any drive for solidarity among us. As tacky as the slogan may sound, the heart lies to the left. But perhaps I am mistaken.”
The author is mistaken because mine lies to the right—literally—although it leans to the left, if that makes sense. All extremes are horrifying to me. I have left behind the Catholic education that I once took seriously, but that I lost, inevitably, after hoping to have a lively conversation with God—and Him, rudely, not responding.
***
Good essayists share their intuitions. Examen de mi padre and essays like La imaginación y el poder (1998) confirm that Jorge Volpi has the steady hand to unravel the skein and subtly connect diverse threads of imperceptible geometries. Like my organs, Volpi’s writing is not seen, just felt. Nobody could guess what is hidden under my skin without a stethoscope, without auscultating my organs. I have always been fascinated by the sounds that can be transferred from the body to the hand when pediatricians touch children’s bellies to hollow, intrusive rhythms.
Volpi stands out for his ability to write without being seen: an approach to writing reminiscent of the wind that moves the treetops and stirs up the sounds of nature. At one point in the book, Volpi cites Ambroise Paré, the barber surgeon who revolutionized the practice of surgery, especially by introducing the idea—revolutionary in its time—that patients need not feel pain in the process. “Monsters,” Paré writes in the preface to his book, “are things that appear outside the course of Nature (and are usually signs of some forthcoming misfortune), such as a child who is born with one arm, another who will have two heads, and additional members over and above the ordinary.” I have no doubt that Paré would have considered me a monster, given the anatomically strange character of what lies within me. I am an anomaly, but an unnoticeable one. My secrets go unseen, although they are in full view of the whole world.
***
To whom it may concern,
Guillermo was first seen by me in February 1992. He was referred by his Paediatrician because of dextrocardia. No cardiovascular symptomatology was present at the time.
After examination, chest and abdominal roentgenography and M-mode and Doppler transthoracic echocardiography it was concluded that Guillermo has Congenitally Corrected Transposition of the Great Arteries in Situs Inversus Totalis and mesocardia (Atrial and visceral situs inversus with mesocardia, Atrioventricular discordance, Ventriculoatrial discordance, side-by-side great arteries) without associated lesions.
I read this in a letter my cardiologist wrote on August 27, 2002, which I still keep with me. It is my safe-conduct to interesting conversations.
***
“Intellectual curiosity about one’s own illness is certainly born of a desire for mastery,” Hustvedt writes. I am not clinically ill, I believe, although I’m overrun by various anatomical peculiarities. Some day, my nonoperational valve will have to be replaced with an artificial one or one from a pig. I haven’t yet decided which I will choose—one of the many unknowns surrounding this condition. The most obvious is the question of why I was born this way. The doctors tell me it’s genetics. My mother, on the other hand, is certain: she says one day, when she was pregnant with me, she was electrocuted.
***
Many writers have suffered a variety of maladies. In Shakespeare’s Tremor and Orwell’s Cough (St. Martin’s Griffin, 2014), as he examines the various illnesses that have plagued different writers, physician John J. Ross says William Shakespeare probably suffered some sort of sexually-transmitted illness. Not only are his works rife with references to syphilis, which is believed to have reached Europe in 1493, thanks to Christopher Columbus; his only verifiable medical condition can be found in his handwritten manuscripts: starting at the age of thirty-six, Shakespeare shook while he wrote. His signature seemed to deteriorate over the years. In fact, Ross tells us, many “misreading errors common in the early printed versions of many of the later plays, including Othello, Hamlet, and Lear, are a direct result of a general deterioration in Shakespeare’s writing.” Ross believes the playwright suffered progressive mercury poisoning; the metal was used to treat patients with syphilis. One symptom of this condition is indeed tremors, which could be a “possible cause of Shakespeare’s worsening handwriting.”
Some writers launch their oeuvre to fame despite their misfortunes and illnesses. English poet John Milton composed his Paradise Lost after life dealt him multiple defeats. Blind, bankrupt, with the deaths of his first and second wives and two of his children on his back, and after being imprisoned in the Tower of London, Milton managed to dictate Paradise Lost (1667)—by that time, he had already lost his sight. Ross tells us, referring to Paradise Lost, “Without the humbling experience of sickness, failure, and defeat, Milton never would have felt it necessary to justify the ways of God to men.” Illness draws us closer to death like a pendulum, swinging between two extremes, which forces the writer to see, in death, his last commitment: a memorable oeuvre in exchange for perpetual darkness. Not all human beings are lucky enough to aspire to such a pact. The writer fears not the possibility of death, but that of wasted writing.
How many masterpieces would never have been written if we shared with the gods the good fortune of eternal life?
***
Why should anyone care if my heart is on the right side and my organs are mirrored, when no one can see them? For physicians, I’m a case study. For the rest of humanity, I’m a case of momentary madness: they don’t believe human beings like myself exist. That is why I hold on to my diagnosis. I have told a lie here, but not deliberately. I just remembered. It says—their words, not mine—that my heart leans instead toward the center. I have also tried to keep my health and my feelings for the world toward the center. You might say this would lead, inevitably, to a boring life. Maybe this is true, but I have had enough; my anatomical peculiarities were not my choice. And I also realize that, little by little, as the years pass, I will have to pay more and more attention to this centric, somewhat deficient heart. Maybe that is why I have been drawn to literature and its silences: to hear my heartbeat more often.
The fact is that my organs will continue being a mystery to medicine. This receptacle that is my body, nonetheless, will escape neither my imagination nor my fictions. The ink I must someday spill into some far-fetched tale—thanks to my organs and their rebellious anatomy—will forever lie in wait for my muscles and my flesh, this permanent revolution within myself, present but hidden, anomalous but operational, as silent as a storm, always mine, now also others’.
Translated by Arthur Malcolm Dixon
