The characters in Happy Like This are smart girls and professional womensocial scientists, linguists, speech therapists, plant physiologists, dancerswho search for happiness in roles and relationships that are often unscripted or unconventional. In the midst of their ambivalence about marriage, monogamy, and motherhood and their struggles to accept and love their bodies, they look to other women for solidarity, stability, and validation. Sometimes they find it; sometimes they don’t. Spanning a wide range of distinct perspectives, voices, styles, and settings, the ten shimmering stories in Happy Like This offer deeply felt, often humorous meditations on the complexity of choice and the ambiguity of happiness.
About the Author
Ashley Wurzbacher’s writing has appeared in the Iowa Review, Kenyon Review Online, Prairie Schooner, Cincinnati Review, Colorado Review, Gettysburg Review, Alaska Quarterly Review, and elsewhere. She lives in Birmingham, Alabama, and teaches creative writing at the University of Montevallo.
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Sickness and Health
Some leave trails of evidence: needles, syringes, thermometers, clumps of hair in the shower drains, the sounds of retching from a bathroom stall, mittens on a bedside stand waiting to be worn at night, on doctors' orders, to prevent self-mutilation. Others leave no trace of their afflictions, which still follow them, shadowy, reminding them constantly and obnoxiously of themselves, like responsibilities. Still others seem already better, their ailments having vanished quickly in this new place, with this new opportunity to start over, be normal. Change, for some, the surest salve.
There is the one with the seizures, presumably fake; the one who draws her own blood; the one who injects herself with saline; the one whose "bulimia," fully under her control, can be shut off as if by a switch; the one who rambles nonsensically; the one poisoned by her own mother; the one whose back pain seems to have no source and no solution; the one who's faked cancer; the one with the headaches; the one who stirred rodenticides into her breakfast cereal; the one caught pricking her finger and letting her blood drop into her own urine samples.
There is Mia in the middle of all this, taking notes.
Her paper is titled, tentatively, "A Qualitative Study of the Effects of Factitious Disorders on the Social Lives of College-Attending Females." It is the most complex study of her career, which isn't saying much, given that her career is only just beginning. Still, Mia is beginning to suspect that it will be the most complex study of her career. It is sociology, ethnography, epidemiology, documentary, creativity. It is, it turns out, the intersection of a few too many things. Mia had thought she'd be able to take these things and braid and bend them like switches into shape (Ambitious, her dissertation director had said of the project, but Mia had wanted a challenge, wanted to push herself), but more and more, she is finding that they're intent on crashing violently against each other, that they are simultaneously unable to harmonize and unable to be separated, like some lovers.
Hers is a methodology limited by its intimacy. She was warned about this limitation at the beginning, when it was decided — by her dissertation director, not by her — that in order to best gather around-the-clock results, Mia should reside, full time, in the same dormitory as the subjects of her study, serving as a kind of resident advisor. She had resisted at first, but as it turned out, the move coincided neatly with her breakup with Ben, with whom she'd spent five years and with whom it had been decided — by her friends, by her family, by Ben, not so much by her — that she was supposed to spend the rest of her life.
The rest of her life: looming, open-mouthed. She was heading straight for it on autopilot but couldn't recall having chosen or engineered it. So she took control; she fled. Which is to say, two months ago she put her things in a storage unit by the freeway and moved into a 180-square-foot room in a university residence hall in a corridor that would eventually become known, due to the eccentricity of its inhabitants, as the Waif Wing and in which she still lives.
OVERVIEW OF FACTITIOUS DISORDERS
Persons with factitious disorders behave as if they are ill or in pain by self-inflicting, faking, or exaggerating symptoms. Persons afflicted with factitious disorders may mimic or lie about symptoms, use drugs, alter diagnostic tests (for example, by contaminating urine samples), induce vomiting, or inject themselves with bacteria in order to induce symptoms and thereby draw attention or solicit the nurturance, sympathy, and/or leniency that they associate with the sick role. Generally, individuals perpetrate factitious disorders because they believe that these benefits and special treatments are not obtainable in any other more practical way. Factitious disorders are diagnoses of exclusion (per exclusionem), meaning they are diagnosed by a process of elimination when no other known diagnoses can be reached with complete confidence from testing or examination. They often come hand in hand with other mental or personality disorders.
Her sample: twelve college-attending females (n = 12) at a large, metropolitan, four-year research university, aged eighteen to twenty-two and consolidated into a common section of campus housing. All of the subjects have been repeatedly hospitalized for symptoms that have been determined to be the result of factitious disorders — that is, fabrications. Aside from their common lack of a biomedical diagnosis, their closeness in age, and their gender, the girls have few universally shared attributes, representing as they do a variety of diverse geographical regions of origin, socioeconomic statuses, educational backgrounds, ethnicities. They know they're being studied but don't know precisely what for; they've given their consent. They make no efforts, as far as Mia can tell, to censor their speech or actions in her presence, as she helps them dress for parties, watches movies in their rooms, attends social events with them, brings them cups of tea when they're too "ill" to leave the building. While they sleep or attend class, she types frantic notes about them into the document that will become her dissertation.
Research has demonstrated that adults with factitious disorders often suffer from personality disorders and have poor coping skills and difficulty forming healthy interpersonal relationships (Monroe and Serrano, 1999; O'Flaherty, 2004; Vanzetti, 2010). It has also been demonstrated that in cases of factitious disorders by proxy, the child or "patient" involved may experience social anxiety, depression, and difficulty relating to or communicating with peers (Becker, Bell, and O'Flaherty, 2007; Smart and Taylor, 2008; Huang, 2011). Existing literature has examined the role of school psychologists in detecting and addressing factitious disorders by proxy in schoolchildren (Roth and Van Rosenthal, 2005). However, no existing studies have addressed the impacts of factitious disorders on the social lives of young adults — specifically young women — old enough to live away from home but young enough to still feel bound to their parents or caregivers, despite physical separation from them. Such a demographic is a fertile one for study, hovering as it does in the liminal space between childhood and adulthood, restriction and freedom, dependence and independence.
Each girl has been assigned a number by which she is to be referred to in Mia's dissertation. Mia memorized their numbers before their names. But she has caught herself, several times in the past month or so, referring to the subjects as "her girls." As if, when the study was over, the article published, she could keep them always with her. As if we can ever belong to each other.
SUBJECT NO. 7: SYNDROME BY PROXY AND CHRONIC PAIN
In the case of factitious disorders by proxy, the perpetrator of the symptoms is someone other than the victim herself. Most often, this takes the form of a parent — usually a mother — inducing or fabricating illness in a child. In such cases, the caregiver derives vicarious attention and sympathy, which gratify his or her own emotional needs, from the medical attention paid to the child (Becker, Bell, and O'Flaherty, 2007; Francis and Ngo, 2012). With age, the child may break free of the fabrication; alternatively, the child may become an agent colluding in the process and, eventually, actively harming herself (Torres, 2003). One subject of this study (n = 1) experienced factitious disorders by proxy as a child under the care of her mother. Born in West Virginia to a coal miner and a housewife who had worked, prior to the subject's birth, as a licensed practical nurse, Subject 7 suffered from strange fevers, vomiting, and hypernatremia (abnormally high sodium concentrations in the blood) induced by her mother through the (ab)use of over-the-counter and prescription medications and injections between the ages of two and nine. Following the discovery of her mother's role in her afflictions, the subject was removed from the care of her parents for several years before she was returned to them at thirteen, all of them having undergone therapy and psychiatric testing.
Lauren, a child like a canary, lowered into dark places where no child and no canary should be. Mia imagines Lauren's childhood: her father with lungs like two slabs of charred meat abandoned on a grill and her mother, for some reason, making problems in the few places in her life where there weren't problems already — adding to coal dust and cave-ins and worry and never enough on the EBT card an endless barrage of office visits, diagnostic tests, and hospitalizations. Don't try to understand, Mia's director had told her when she'd wondered aloud how a parent could do such a thing to a child, to Lauren, because you never will.
But Mia does try. She thinks of how Lauren's family's church raised money to help pay the medical bills they didn't realize were unnecessary, preventable. How Lauren's classmates, led by the teacher from whose class she was almost perpetually absent, raised the money to grant what Lauren's mother had indicated was eight-year-old Lauren's dying wish: a ride in a hot air balloon. Mia pictures Lauren and her mother floating above the Appalachians, as high in the sky as Lauren's father was deep down in the mine. She pictures Lauren's father, unaware of his wife's ruse, never home and often drunk, carbon-streaked and grateful for the darkness and privacy his subterranean workplace afforded him, in which he could hang his hard-hatted head and cry in silence, humbled by the support he'd received from his fellow men though he'd refused, out of pride, to ask for their help, and later, shamed by his wife and disgusted by the child she'd used as her pawn.
But weren't we at our closest there in the hospital waiting room? his wife — Lauren's mother — asks him, in Mia's fantasy. Clinging to each other, remembering their probably forgotten, coal-smudged love, praying for their daughter, the one thing that still bound them to each other. At the very least, she may have told him, desperate to justify herself, it kept you above ground. It bought you days in the sun you wouldn't have had; it bought you time up here with me, with our girl. A sick woman, certainly, hovering over Lauren in hospitals, explaining her "pain," refusing to leave her side (seemingly out of devotion, truly out of the knowledge that the girl's symptoms would subside in her absence), wearing heels and her best JCPenney dress, awash in attention and sympathy for her broken daughter. Maybe she needed this, did this, because she couldn't admit that it was she — exhausted, bored, tired of the little black flecks of carbon in her hair and in her lungs, tired of her marriage, tired of herself — that was broken.
After she was removed from her parents' home, in the care of her aunt, Lauren began experiencing chronic pain — her back, her neck, her abdomen. Back into the hospital she went, her aunt by her side, dumfounded. No explanation, no diagnosis. "Seizures" from which Lauren could be roused suspiciously easily by the mention of a favorite food or the presence of a longed-for friend or family member followed a few years later. Her doctors concluded, when no other explanation offered itself, that this pain and these seizures, unlike Lauren's childhood ailments (to which they seemed to be unrelated), were her own fabrications.
In the Waif Wing, Lauren can often be found lying on the mock granite hallway floor, staring at the ceiling. The other girls have adjusted to her habit, stepping over or around her as the need arises; it was Mia's initial hypothesis that this dearth of attention, this proceeding-as-normal, would deter Lauren's behavior. Indeed, her seizures seem to have stopped, quite abruptly, following her move into the Waif Wing, but the pain persists, and she claims an inability to sleep in a bed, insisting that mattresses hurt her back. Cold stone, on the other hand, has healing powers, straightens and soothes her spine. So she says. She is, after all, a child of mountains and mines, a child with a mother hard as rock.
When asked by Mia, one day, to sketch her pain, Lauren drew a rose. Her spine, she narrated as she drew, was the long and gently curving stem, full of thorns that sprouted from each fertile nerve and patch of flesh, and the blossom was her head, registering her pain in bursts that were red and furious but that opened slowly like petals, taking their time.
What afflicts Subject 7? What does a physician, a surgeon, a student, do with an odd horizontal habit and a drawing of a rose? Though all of Lauren's doctors have concluded per exclusionem that her pain must be no pain at all, Mia isn't sure. She pictures Lauren much younger, not understanding, only knowing that when she's hurting, hospitalized, her parents and doctors and friends hold her more closely than before. As a child, she was likely unable to make the connection between her chronic illness and her mother's care, so profound was her trust of her mother. Alternatively, she may have feared abandonment if she'd stopped being sick, feared losing her mother if she confided the truth in a doctor, an outsider. Perhaps she still fears these things now. Perhaps, Mia thinks, she is simply skilled in the cold economy of purchasing love with suffering. But isn't this a transaction motivated by pain? Genuine, inexpressible pain?
Maybe Lauren's pain, this time, is true and sincere and truly and sincerely beyond science or scholarship. Maybe a just-so cocktail of psychology and routine can put pain where it wouldn't otherwise be, in a place that's hidden from radiology and reason. Is it possible? Mia wonders. Who's to say that real pain couldn't bloom from a hole dug out where there once was none?
Mia imagines Lauren and her mother up in that hot air balloon, the world below them looking like an outspread board game, something whose rules don't matter, something that might be folded up and put away. The wind in their hair. Mia hates this woman and what she did to Lauren, but whatever they saw that day from the sky must have stayed with the girl, must stay with her still. Strange as it may seem, Lauren speaks often of missing her mother, her home, the place where she was a phony patient in a room full of flowers, back where the Appalachian range bends northward like a great scoliotic spine.
DATE: TWO CASE STUDIES
There are scores of case studies in Mia's notes, dates and dances and parties. Take, as a sample, this one: they are driving to a bowling alley, Kat (Subject No. 1: seizures) in the front seat, her date at the wheel, Lauren and her date in the back, Mia squished against the back door on the other side of Lauren's date, whose knee knocks against hers when the car hits a bump. At the bowling alley, they slip their feet into unsanitary shoes. Kat (no seizures today) and her date spend the evening draped across each other, limbs dripping over shoulders like fondue, engaged in giddy I-don't-know-you-but-I-like-you conversations that make Mia feel embarrassed on both of their behalves. Their interactions are sickening in an entirely mundane way. She watches, records notes.
Mia barely participates in the game, slinging the ball with apathy down the lane when it's her turn. Lauren's date misspells her name — M-E-A — when he enters it into the scoring system, praises Mia, and offers to help her improve her technique. He's a junior, a few years older than Lauren, whom he pointedly ignores. He watches Mia, who watches Lauren watching her date watching Mia. Lauren laughs too loud and at the wrong things. Mia excuses herself and retires to the restroom to write and to hide somewhere away from his eyes. When she returns, she finds Lauren guiding her date's hands onto her shoulders, where they squeeze, massage, work their way down her spine. Notes are scribbled, observations are made: how pain, or its pretense, is used to build bridges. That feels great, Lauren says. I really needed this.
When her date locates Mia, crouched behind rows of multicolored bowling balls like giant petrified scoops of ice cream, he lets his grip on Lauren's shoulders loosen, and Lauren grabs his hands, restoring them to their place on her body.
It's just, Lauren is saying to her date as Mia approaches, my grandmother just died. I'm still kind of getting over it. We were really close.
Lauren makes her eyes big, tries to sink those eyes into him, brand him with their heat.
Mia hasn't heard anything about a grandmother's death and is quite certain that Lauren is lying. Lauren's behavior is consistent with existing research that indicates that, when attention or sympathy begins to wane, factitial patients often fabricate secondary crises in hope of engendering renewed concern and soliciting additional nurturance (Bell, 2008; Fordham and Fulton, 1995). She scribbles all the way home, in her spot in the back seat of the car, Lauren in the middle this time, laying a hopeful head on her date's cold shoulder.(Continues…)
Excerpted from "Happy Like This"
Copyright © 2019 Ashley Wurzbacher.
Excerpted by permission of University of Iowa Press.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
. I . Like That,
Sickness and Health,
What It's Like to Be Us,
Happy Like That,
. II . Like This,
Make Yourself at Home,
The Problem with You Is That,
Happy Like This,
What People are Saying About This
“I love these dark, lyrical, sinewy stories about women’s relationships with their bodies and with each other. It’s the sort of theme that could feel irritably well-trod, but that’s not the case here at all; these stories surprised me at every turn. And the writing is so gorgeous!”Carmen Maria Machado, judge, 2019 John Simmons Short Fiction Award
“Equal parts graceful and astonishing, the stories in Happy Like This do the brave work of building upon established traditions to create worlds and languages all their own. The result is a sweeping, insightful and compassionate portrait not only of women’s lives, losses and loves, but of their anger, its power and the fierce sisterhood forged between those who express it. I ended this book knowing that every story had embedded itself in my body like language; Wurzbacher’s writing has become part of me, and I am forever grateful for it.”Allie Rowbottom, author, JELL-O Girls
“I fell in love with these stories from page one. Happy Like This is a funny, touching catalog of women’s generosity toward each other and themselves, of the secrets we need to keep and the paths we must take in order to live more fully. A powerhouse of a collection.”Danielle Lazarin, author, Back Talk
“Rumor has it that Alice Munro in responding to the question ‘Do you consider yourself a feminist?’, replied thusly: ‘If you mean do I take the lives of women seriously, yes.’ Ashley Wurzbacher’s wonderful collection of stories made me think of that writer, and that answer, repeatedly. I love this book.”Antonya Nelson, author, Funny Once
"What a gorgeous, varied, brilliant and accomplished collection of stories! Characters who navigate our crazy world and its complexitiessocial, political, sexual, financialwith humility and grace and always an urge to know more, to feel more, understand better; characters whose life experiences present the reader with a range perspectives you might expect any debut author in her right mind to shy away frombehavioral science, body-building, ballet, speech pathology, plant physiology, and so much more. Most impressive of all: on every page, moments of truth and beauty so perfectly, easily and indelibly rendered in lines to make you catch your breath and wish to read them over and over. This is an astonishing debut collection. I am so very, very happy that Happy Like This exists. A must read!!"Gregory Spatz, author, Inukshuk