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The Sickness

The Sickness

by Alberto Barrera Tyszka, Maragret Jull Costa (Translator), Chris Adrian (Introduction)

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A profound and philosophical exploration of the nature and meaning of illness, Alberto Barrera Tyszka's tender, refined novel interweaves the stories of four individuals as they try, in their own way, to come to terms with sickness in all its ubiquity.
Dr. Miranda is faced with a tragedy: his father has been diagnosed with terminal cancer and has only a few


A profound and philosophical exploration of the nature and meaning of illness, Alberto Barrera Tyszka's tender, refined novel interweaves the stories of four individuals as they try, in their own way, to come to terms with sickness in all its ubiquity.
Dr. Miranda is faced with a tragedy: his father has been diagnosed with terminal cancer and has only a few weeks to live. He is also faced with a dilemma: How does one tell his father he is dying? Ernesto Duran, a patient of Dr. Miranda’s, is convinced he is sick. Ever since he separated from his wife he has been presenting symptoms of an illness he believes is killing him. It becomes an obsession far exceeding hypochondria. The fixation, in turn, has its own creeping effect on Miranda’s secretary, who cannot, despite her best intentions, resist compassion for the man. A profound and philosophical exploration of the nature and meaning of illness, Alberto Barrera Tyszka’s tender, refined novel interweaves the stories of four individuals as they try, in their own way, to come to terms with sickness in all its ubiquity.

Editorial Reviews

Publishers Weekly
Dr. Andrés Miranda, a well-known advocate of "the transparent relationship between doctor and patient," has trouble following his own advice when his father is diagnosed with stage IV lung cancer. Edifying digressions addressing economic injustice and the plight of women in a society dominated by machismo culture, as well as lengthy medical anecdotes, feel somehow forced, as though Tyszka (Hugo Chàvez) wanted to give the reader a little respite from the predictably voracious advance of the terminal illness, or Miranda's own oddly disassociated emotions when confronted with his rapidly deteriorating father. The novel gathers steam when Miranda's secretary decides to respond to the desperate e-mails of a hypochondriac, an ex-patient who has been stalking her boss, in order to avert a possible catastrophe. This parallel plot evolves into an engrossing dialectic, and is possessed of all the dramatic portent and subtle character development that are strangely absent from the main storyline. (Mar.)
From the Publisher

"[I]n 'The Sickness' Mr. Tyszka confronts 'illness's infinite power' in its corporal and psychosomatic forms. The strength of this bold and devastating book (translated by the always dependable Margaret Jull Costa) is that the author neither moralizes about sickness nor uses it as a metaphor. It is simply there, its meaning altogether inexplicable." —Wall Street Journal

"This is great book by a great writer."
—Chris Adrian, author of The Great Night

"Barrera Tyszka not only presents the would be medicine with confident realism, creates sympathetic characters and writes gorgeous prose, he's also a thinker and peppers his narrative with meditations on illness, the complications of lying, and the nature of physical pain."
Shelf Awareness

"Tyszka's novel does not belabor the moral ambiguities of illness but draws them with clean, scalpel-sharp precision."

"The Sickness is refreshingly clean in its storytelling yet very complex in character."
Times Literary Supplement

"Alberto Barrera Tyszka distills an eerie fableof identity from a hypochondriac's psycho-drama and a looming family crisis."
—The Independent

"Tyszka is a perceptive, original writer. He has brought an unusually sophisticated understanding to a wonderfully intense, little novel. No sentimentality, no polemic, just emotion at its most resonant."
—Eileen Battersby, The Irish Times

"Powerful writing [which does] not let you off or let you down."
The Lady

"Well-pitched, gentle and suggestive . . . philosophy in the story."

Product Details

Tin House Books
Publication date:
Product dimensions:
5.00(w) x 7.60(h) x 0.70(d)

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Read an Excerpt


By Alberto Barrera Tyszka

Tin House Books

Copyright © 2012 Chris Adrian
All right reserved.

ISBN: 978-1-935639-25-1

Chapter One

"Are the results in yet?"

No sooner are the words out of his mouth than he regrets having spoken them. Andrés Miranda wishes he could catch the question in midair and send it back where it came from, hide it away again beneath a silence. But he can't, it's too late. Now all Andrés has is the chief radiologist's face, his lips a knot in the middle of his mouth, his dark eyes like two stains, as he offers Andrés a smile of strained sympathy and hands him a large brown envelope. The radiologist says nothing, but his very expression is a judgment: multiple lesions suggestive of a metastatic disease, for example. That, more or less, is what the knotted lips are saying. Medical people rarely use adjectives. They don't need to.

"Are the results of the CT scan in as well?"

The radiologist shakes his head and shifts his gaze to the corridor.

"I was told they were being sent direct to you."

Andrés feels strangely embarrassed, as if both of them were making a tremendous effort not to upset the fragile balance of the moment. He thanks his colleague and makes his way back to his office. No one has told him as much, he hasn't even seen the X-rays, he hasn't been shown the results, and yet he knows that his father has cancer.

Why do we find it so hard to accept that life is pure chance? That is the question Miguel always asks before any operation. There they all are wearing green gowns, gloves, and surgical masks; the white light of the operating room seems to float on the cold air-conditioned air. And then Miguel picks up a scalpel, looks at Andrés, and asks: "Why do we find it so hard to accept that life is pure chance?" Some of the nurses dislike this as a prelude to an operation. Perhaps they realize that it's not exactly a good way to start, almost a prior justification in case anything should go wrong. Andrés is sure this isn't so, for he knows Miguel well; they've been friends since they were students. There's no cynicism in that question. It seems, rather, an expression of self-compassion, a kindly prayer; a way of recognizing the limits of medicine in the face of nature's infinite power or, which comes to the same thing, the limits of medicine in the face of illness's infinite power.

As soon as he goes into his office, as soon as he closes the door, he begins to tremble. He feels as if, suddenly, his body were breathing differently, making different sounds and movements, as if he bore inside him some helpless, stumbling creature, as if he were giving birth to a disaster. He hurriedly makes his way over to the chair behind the desk and sits down. He's still holding the envelope. Inside are two chest X-rays. Bluish photos, harsh, sharp transparencies. His father's body transformed into a blurred drawing in which, however, death is all too cruelly clear. Andrés feels afraid, even though this isn't a new fear: it's been there for years, stalking him. It must be the same fear which, for no reason and yet so often, leaps out at him from his own shadow. It's the anxiety that weighs on his chest some nights, preventing him from sleeping. We're probably all born with such a fear, which is as vague as it is overwhelming. It wanders about inside us, not knowing where to go, but never leaving us. It prepares itself, trains itself, waiting for the right moment to appear. It's an omen, a voice that doesn't quite know yet what it has to tell us. But it's there, an indecipherable, incomprehensible sound, an insistent drip-drip, an alarm call. He's been hearing it for years, running away from it, trying to frighten it off, but never succeeding. Now, that anxiety has taken on a shape: the face of the radiologist, with its evasive, resigned expression. Andrés has seen it too many times before. He himself must have worn the same expression on more than one occasion. It's the illustration that accompanies a bad diagnosis, the first installment of an expression of condolence. Is he ready for this? He's not sure.

The phone rings. It's Karina, his secretary. She tells him his father is on the line again, asking if he can speak to him.

"Am I so ill that you don't even want to talk to me?"

This is his father's opening line. Delivered in a jokey tone, of course. Andrés recognizes the nervousness that lies behind. It's a classic strategy. Many patients opt to use it, positioning themselves on a thin line where everything is simultaneously half jest and half serious; they try to act normally, when, in fact, they're terrified and haven't stopped thinking, not even for a second, about the possible result of their tests. They've spent hours pursued by the fear of mortal illnesses; they've felt an odd twinge in every movement they make; they've seen suspicious blotches where before they saw only skin. Then they go to the doctor, trying to look strangely natural: they smile, but appear to be on the verge of tears. They ask questions like the one his father has just asked.

"I didn't phone you earlier because I've only just seen the results of your tests," Andrés says.


"In principle, everything's fine," he says, touching the sealed edge of the envelope.

"In principle? What the hell does that mean, Andrés?"

"Calm down, Dad. I'm telling you that you're fine.'

"You're telling me that, in principle, I'm fine: that's rather different."

Andrés is perfectly familiar with this stage too. Generally speaking, patients need to squeeze every word, wringing out its most precise meaning, with every nuance washed away. They want to clear up any doubts, even about punctuation. A patient always suspects that he's not being told the truth or at least not the whole truth, that some information is being withheld. That's why they insist on delving desperately into everything, even language. In this case, though, his father is right. Andrés said "in principle" because he hasn't yet looked at the X-rays. Why doesn't he take them out now, why doesn't he open the envelope and study them? What is stopping him from looking at those results?

The radiologist's face hangs like a balloon in his office. Hospital corridors tend to be full of such balloons. They drift slowly through the air, identical, tenuous bits of plastic on which are painted frowning brows, grave mouths, sober looks: all the outward signs of helpless resignation. It's a ceremony, a clinical protocol. Hospitals are places through which one passes: temples to farewells, monuments to partings.

"I said 'in principle' because I still don't have all the results. The ones I've just been given are fine." "Which means that ..."

"That there's nothing to worry about, Dad," Andrés says, interrupting him, already embarrassed. He can't stand lying for any length of time. "Go out for a walk, have a coffee somewhere with your friends. Everything's fine, really."

"Are you sure?"

"Yes, I'm sure."

There is a brief silence. A tense, unbearable pause. Andrés wants to hang up. He can sense that his father is still uncertain, still in doubt. He can imagine him in his apartment, sitting on the arm of the green sofa beside the phone, gripping the receiver, thinking. Suddenly, Andrés feels as if he were poised above a chasm of nothingness, a precipitous drop. They're suspended for a moment not in silence, but in the void, until:

"You wouldn't lie to me, would you?" His father is speaking from his very bones, in the harsh but intimate voice with which all bones speak. "Andrés," he goes on, "if there was something seriously wrong with me, you wouldn't ever hide it from me, would you?"

Andrés has a hedgehog on his tongue. His throat fills with pineapple rind. Despite himself, his eyes well up with tears. He's afraid his voice might fail him. He makes a huge effort to speak.

"I would never deceive you, Dad," he says at last, with as much conviction as he can manage. "That's all I wanted to hear. Thank you."

Dear Dr. Miranda, I trust you will remember me. It wasn't easy to get hold of your e-mail address. If you knew what I've been through to find it! But that's another story. What matters is that I'm here now, writing to you. Not that I like the fact. I've never felt comfortable writing. It's not me, it doesn't feel right, I don't know where to put the words or what to say. But in a way, circumstances are forcing me to write. I have no other option. I need to see you urgently, Doctor. I'm desperate. For three months now, something very strange and mysterious has been going on. When I call your office, I'm told you're not in or can't come to the phone. If I ask to make an appointment, the person at the other end says "No," she can't do that. And she won't explain why either. I'm sure you know nothing about this situation, nothing at all. You would never treat me like that, but if that's the case, who is responsible for all this? And why? This is the reason for my letter, Doctor. It's the only way I have now of asking you for an appointment. My situation remains the same, with my health deteriorating by the day. Reply directly to this address. Please, trust no one else. I need to see you as soon as possible. Thank you for your attention and, as I say, I'm here, waiting for your reply. Ernesto Durán

Blood is a terrible gossip, it tells everyone everything, as any laboratory technician knows. Hidden inside that dark fluid, stored away in little tubes, lie murky melodramas, characters brought low, or sordid stories on the run from the law. When his father fainted, Andrés insisted on him having a whole battery of blood tests. His father protested. He tried to make light of the matter. He preferred the term "dizzy spell" to "fainting fit," and insisted on this almost to the point of absurdity.

"It was just a dizzy spell," he kept repeating, blaming it on the humidity, the summer heat.

It was, according to him, the fault of the climate rather than an indication of some physical ailment. But the truth of the matter is, he had collapsed on the floor like a sack of potatoes in front of the woman who lived in apartment 3B. They'd been talking about something or other—neither of them could remember what—when suddenly his father collapsed, and the neighbor started screaming hysterically.

"I thought he'd died. He was so pale! Almost blue! I didn't want to touch him because I was afraid he might already be cold! I didn't know what to do! That's why I started screaming!" says the neighbor.

A few seconds later, his father, once he'd recovered consciousness, had tried to calm her down and reassure her that everything was fine, that nothing very grave had happened. Perhaps he had told her, too, that it was just a dizzy spell. Nevertheless, that same afternoon, the neighbor phoned Andrés to let him know what had happened.

"The old busybody!" his father grumbled when Andrés arrived to pick him up and drive him to the hospital.

While the nurse was taking the blood samples, Andrés suddenly noticed that his father had grown smaller. It had never occurred to him before to notice his size, but seeing his father there, arm outstretched, eyes fixed on the ceiling, so as not to have to look at the needle, it seemed to him that his father had become shorter, had lost height. Javier Miranda is a fairly tall man, almost five foot ten. Tall and slim, with a rather athletic build. He always walks very erect, as if his body didn't weigh on him at all. Despite his age and the fact that he's gone gray, he looks cheerful and healthy. His curly hair has won out over any incipient baldness. His skin is slightly tanned, the color of light clay. His eyes are brown too. He's never smoked, only drinks occasionally, goes for a walk every morning in the park—Parque Los Caobos—avoids fatty foods, has fruit and muesli for breakfast, and every night eats seven raw chickpeas as a way of combating cholesterol. "What went wrong?" he seemed to be asking himself. He had sidestepped time rather successfully. Everything had been going relatively well until, one afternoon, that inexplicable fainting fit had stopped him in his tracks. It was that brief wavering of his equilibrium that had brought him to this place and abruptly transformed him into this weak, wounded, small—yes, smaller—person. The words "Sickness is the mother of modesty" came unbidden into Andrés's mind. They appear in Robert Burton's The Anatomy of Melancholy, published in 1621. It's required reading in the first term of medical school. The quote bothered him though. It struck him as not so much sad as stupid; behind it lay the desire to make of sickness a virtue. He looked at his father again. Isn't sickness a humiliation rather than a virtue?

Up until now, his father's health had only ever succumbed to the occasional common cold, and a brief urinary infection two years ago, but that was all. He enjoyed enviably good health and, so far, there had been no other worrying signs. Andrés, however, had a bad feeling. The whole situation produced in him a peculiar sense of apprehension. With no evidence on which to base that feeling, he thought for the first time that the worst could happen, that it might already be happening. It irritated him to feel hijacked by a mere hunch, to be taken hostage by something as irrational and unscientific as a bad vibe. His father glanced across at him. Andrés didn't know what to say. It suddenly struck him as pathetic that the fate of a sixty-nine-year-old man could be summed up in just four tubes of dark fluid, O Rh positive. What would his father be feeling at that moment? Resigned? Ready to accept that he was reaching a preordained destiny, that this was a natural conclusion to his life; that now he was entering a stage when people would stick needles in him and when he would inhabit a world dominated by the aseptic smell of laboratories? He again looked hard at his father and was filled by a frightening sense that it was no longer his father meekly putting up with being pricked, touched, and bled, it was just a body. Something apart. An older, more vulnerable body in which his father's spirit writhed in protest. Spirit was an odd word. Andrés hadn't used it in ages. He felt that he was using it now for the first time in years.


Excerpted from THE SICKNESS by Alberto Barrera Tyszka Copyright © 2012 by Chris Adrian. Excerpted by permission of Tin House Books. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Meet the Author

Alberto Barrera Tyszka, poet and novelist, is well known in Venezuela for his Sunday column in the newspaper El Nacional. He cowrote the internationally bestselling and critically acclaimed Hugo Chávez (2007), the first biography of the Venezuelan president. The Sickness won the prestigious Premio Herralde—an honor previously bestowed on Roberto Bolaño and Javier Marias, among others—and was shortlisted for the Independent Foreign Fiction Prize in 2011.

Margaret Jull Costa is the translator of many Portuguese, Spanish, and Latin American writers, among them Javier Marías, Bernardo Atxaga, Fernando Pessoa, and Eça de Queiroz. She has won many awards, most recently, the 2011 Oxford Weidenfeld Translation Prize for José Saramago's The Elephant's Journey.

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