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- [00:01]
Emily Dufton
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- [00:30]
Jonathan Gleason
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- [00:58]
Marshall Po
Hello everybody. This is Marshall Po. I'm the founder and editor of the New Books Network, and if you're listening to this, you know that the NBN is the largest academic podcast network in the world. We reach a worldwide audience of 2 million people. You may have a podcast or you may be thinking about starting a podcast. As you probably know, there are challenges basically of two kinds. One is technical. There are things you have to know in order to get your podcast produced and distributed. And the second is, and this is the biggest problem, you need to get an audience. Building an audience in podcasting is the hardest thing to do today. With this in mind, we at the NBM have started a service called NBN Productions. What we do is help you create a podcast, produce your podcast, distribute your podcast, and we host your podcast. Most importantly, what we do is we distribute your podcast to the NBN audience. We've done this many times with many academic podcasts and we would like to help you. If you would be interested in talking to us about how we can help you with your podcast, please contact us. Just go to the front page of the New Books Network and you will see a link to NBN Productions. Click that, fill out the form, and we can talk. Welcome to the New Books Network.
- [02:06]
Emily Dufton
Hi, and welcome to New Books Network. I'm your host, Emily Dufton, and today I'm talking to Jonathan Gleason, author of the new essay collection Field Guide to Falling Ill, which was just released on January 27th by Yale University Press. Jonathan is a writer and an instructor at the University of Chicago, a medical interpreter, and a recent graduate of the University of Iowa's MFA program in Creative Writing. Field Guide to Falling Ill is his first book and the winner of a Host of prizes, including the inaugural Yale Nonfiction Book Prize and a grant from the Elizabeth George Foundation. Field guide covers a range of topics from the antiretroviral medication AZT to blood clots to Jonathan's imprisoned uncle. All written in lyrical, swift, moving prose. And I'm so excited to talk about these topics and more with him today. Welcome, Jonathan.
- [03:06]
Jonathan Gleason
Thanks so much for having me.
- [03:09]
Emily Dufton
So, first of all, why a Field Guide to Falling Ill? Because I think we're all used to field guides for, like, butterflies or flowers, but not necessarily for things like incarceration or witnessing crimes or being tested for hiv, which are all subjects that. That appear in your book. So why did you title this A Field Guide to Falling Ill?
- [03:33]
Jonathan Gleason
Yeah, absolutely. I mean, part of the reason is that in nonfiction there's a tradition of, I think, homage and reference to other big informative texts that you've read. And I was really influenced by Rebecca Solnit and her Field Guide to Getting Lost. When I first started some of these essays way back in the day, you know, I liked the possibility and expansiveness of a field guide, the way that it looks at kind of our interaction with things out in the world. Loose, kind of in the wild, in this case. That landscape of the wild isn't necessarily the literal natural world, but it is medicine in relationship to other areas, other fields, politics, culture, the way history has influenced these things. It's not exactly the bite sized and digestible way to identify illnesses out in the world, but it does have to do with this connection between a person who might go out into the world looking for some kind of roadmap or guide to understanding their own relationship to different illnesses, medical industries, etc. So, yeah, that's, I think, why the name really stuck. Yeah, and I was kind of surprised to see that it stuck around over many, many years. But in the end, when it came a time to really land on a title, it still just felt right, the expansiveness, the breadth of it. Although this book is about illness, it does think about ill illness really broadly to cover things from, you know, heart disease, very traditionally considered, you know, an illness one many of us are concerned about, to addiction, which is, you know, debated whether we should be thinking of that through, like, the model of illness or something else.
- [05:19]
Emily Dufton
Can you tell us a bit about your background as a writer and how you chose both the essay format and the topics that you include?
- [05:27]
Jonathan Gleason
Yeah, the essay form has really always spoken to me, called to me. I sometimes say the genre chooses you in a kind of mysterious way. I started thinking that I would certainly go into a stem field. I wanted to be a doctor. Maybe unsurprisingly, you know, I did a bunch of prerequisites in pursuit of that goal. But then something happened, something changed. I started to discover some of the ideas that are actually present in this book. And they've made me start to question whether it was medicine that I wanted to practice or looking at medicine and illness in a broader context. And so for a while, I frankly just wasn't sure what I wanted to do. I wasn't sure if I'd be a writer. And I got really lucky. I met some mentors who really encouraged me to write in the nonfiction genre using this kind of latent knowledge that I had about science and medicine. And that's where I really got my start as an undergrad writing. And of course I spent a long time not really sure if I would try to develop as a writer and really make it my career. But I kept encountering stories, stories, or having experiences that intersected with medicine in one way or the other. So for a long time, I. I wasn't necessarily thinking about these essays as a single self contained book. I was writing a lot of different things, not just about illness and medicine, but again, that kind of, that topic just kept calling to me. Whether it was because of my own innate interests in, in medicine and its context, or because I would have certain experiences that I felt like I wanted to write about. You know, my mother unfortunately suffered a heart attack. She, she. But that experience I wanted to write about. And it was at the same time, as one of the essays in the book explores, that I was hearing about, you know, a young black man who was being denied a heart transplant. At the same time, I was having experiences as a lifeguard where someone had a heart attack on our. Our pool deck. And these things started to speak to each other and then an essay would emerge out of it as I started to make sense of how all these different threads communicated with one another. And honestly, that just happened kind of again and again. I would. An experience, I would want to write about it. It had to do with medicine. And eventually I wound up with this stack of essays that had been published or unpublished. And I started to see this kind of internal architecture below the superficial, as in just on the surface topic of medicine. I started to explore how fear really mediates our experience with the world. And medical anxiety can really bring out sometimes the worst in us and how we can overcome that, how medical instit are really responsible for how we, you know, navigate intimacy sometimes with partners or just how we get access to the kind of treatment we need or lack access, unfortunately, in a lot of cases. So, yeah, then eventually the essay, the, you know, the titular essay, Field Guide to Falling Ill, was about my experience of falling suddenly ill with a blood clot. And that was when things really clicked for me that there was enough here, there were enough, you know, repeated them and threads throughout these essays that maybe this could be a cohesive book united not just by the theme of medicine, but by these sort of underlying preoccupations and topics.
- [08:58]
Emily Dufton
Right. I loved the way that there are so many different ideas braided into throughout the book, but even into individual essays. And a lot of things that, like, you would start in one direction and then, you know, go into this other one. But it all made sense. And what was the name of the. Greg Louganis, the Diver. I had not heard that name in years. And then it's in this essay. I was like, oh my God, Greg. Luke Ganis, I really appreciate. You could tell that there was a lot of thought and there was a lot of sort of foresight wrapped into the writing not only of individual essays, but of the book as a whole. You can tell you put the work in, and I really appreciated that. But I also wanted to ask about your research, which also seemed very thorough in A Difficult man, which was probably my favorite essay in the collection. You listened to what seemed like hours of recorded conversations between the two people you profile in this essay. How did you find this material and what made you want to incorporate this kind of research and reporting alongside more personal memoir style essays as well?
- [10:03]
Jonathan Gleason
Yeah, great question. And I'm so glad you appreciated this essay. It was one of the more recent essays I wrote. I sometimes feared that it was perhaps a bit too dense or just not personal enough to live alongside some of the other essays. But, you know, I really loved it. I put a lot of work into it. And yeah, I'm glad that it spoke to you. Yes, absolutely. This essay required many hours of listening to recordings between Michael Cowan and Joseph Sonovan, who were both AIDS activists. Michael especially was an activist and also like a singer and performer and was someone who had HIV in the early years of the crisis. Joseph Sonovan was a doctor who worked in a number of different areas. You know, he trained as a physician, but then wound up working kind of more hands on with a lot of patients, specifically gay men in New York during the crisis. Yeah. And I really found my way to this essay and sort of the kernel that made it work. Through by accident and surreptitiously or serendipitously and because of a lot of generous help from other people. So I was working on an essay on azt, which was one of the. Which was the first release that was supposed to treat hiv. And that essay appeared in a short form in another magazine. And I love that essay, but it was a little bit abstract because it is about a drug and it was about medication, and it didn't maybe have that, like, human element to it that I think really adds some, like, warmth and dynamism to these essays. And then in trying to expand that essay, I discovered Joseph Sonovand. And I knew immediately that I wanted to write about him. He's such an interesting character. He's very personally conflicted. He was kind of this unsung hero, actually. He was pretty well known in his day, but in many ways I don't hear about him much in terms of the list of heroes of the AIDS crisis. But then later on, he came to perhaps diminish his own reputation by insisting that HIV was not the cause of aids, far past the time when medical knowledge had proven that HIV was in fact the cause. So he's this very complicated character. He did a lot of great work, but he has this complex history where he, again, kind of diminished his own reputation. And so I really wanted to explore him and his psychology and how it tracked the development or kind of the rise and fall of azt, because he was always a skeptic of azt and he was really proven right about that. AZT was positioned as this silver bullet. It was given a lot of research funding, sometimes at the expense of other treatments that weren't going to cure hiv, but they could help and extend the lives of patients with HIV and AIDS by treating their opportunistic infections. And he was a big proponent of, you know, pursuing these other routes. He was very important for community research as a form of getting drugs approved. He really believed in, like, listening to patients and using that kind of on the ground knowledge to both formulate treatments. And he just took these. These patients seriously in their own experiences. So I was really interested in Joseph Sonnebend. His papers are held at the New York Public Library. So I set up a research trip to go out there and look at his papers. I was really excited about it. I thought this would unlock the whole essay. I show and I start reading through the different boxes that I've requested and wow, he was sort of a dry, factual individual in his correspondences, in his research writing, you know, I found one great letter between him and Susan Sontag, which appears in the essay. But I just. I wasn't getting the kind of information that was really bringing him to life on the page. And I had this really sort of nausea inducing moment after, like, hours in the archive, just realizing that this was not going to result in the essay that I wanted it to. And so I wound up saying, okay, this is not proving fruitful. I think I need to pause and consider redirecting, even though I only have, you know, a few more hours in the city before I need to go back to Chicago. So I wasn't sure what to do. But I had seen Michael Cowen's name a lot in the papers of Joseph Sonneben. I knew they were close. I knew they were friends. And I thought, well, maybe I can approach this kind of from the opposite direction. Like, maybe Michael Cowan is the key to understanding this really important figure of the Dr. Joseph Sonneben. And I looked up where his papers were held, and they just so happened to be at the Greenwich LGBTQ center across town. So I frantically made a call to the archivist there. They said, we're closing in a few hours, but if you want to hurry down here, we'll see what we can do. I rushed across town. I wound up running into Lou, one of the archivists there in the lobby, who said, I'm so sorry, but we hold Michael or, yeah, Michael Cowan's papers off site. You'll have to come back another day to see. Which was, yeah, a disappointment. My. I was flying out the next day. I didn't really know when I would be able to come back. So this was, you know, just going to necessitate another research trip. But they said, we do have a lot of recordings that Michael Cowan made. He was a pretty, like, obsessive documenter of his life. He recorded a lot of phone calls, you know, music samples, even sometimes just like, commercials and ads in these strange, like, mixtapes. And so I went home to Chicago. I sent an email back, and I got access to this Dropbox with just hours and hours of, like, see what seems like everything Michael Cowan ever recorded, including these amazing recorded phone conversations between him and Joseph Sonovan, in which you can see their friendship develop, their theory of HIV and AIDS develop. They talk about, you know, the medical industry and their frustrations with it. You know, they develop their model of safe sex in these tapes, as well as their theory of the multifactorial model that was later proved incorrect. So I really just got to see the Whole sweep of their relationship, including all of those small textual elements that you just usually can't get from maybe a Wikipedia biography of someone. And that really brought the essay to life. And so as far as Joseph Sonovand was kind of a key to understanding the rise and fall of azt, and Michael Collin really became the key to understanding Joseph Sonabent. And in the end, you know, it's their relationship that I think really carries this essay and really became the core of it. We all have that dream trip we've been wishing we could go on, but too often life or usually price gets in the way.
- [17:16]
Emily Dufton
That's why Priceline is here to help.
- [17:18]
Jonathan Gleason
You turn your dream trip into reality. With up to 60% off hotels and up to 50% off flights, you can book everything you need for your next adventure. Don't just, just dream about that next trip. Book it with Priceline. Download the Priceline app or visit priceline.com.
- [17:34]
Emily Dufton
And book your next trip today. Go to your happy price, Priceline. That's an amazing story of almost thwarted and then incredibly successful archival research. I'm thrilled you got those. I had a question about Sonovan. Was he a gay man as well?
- [17:51]
Jonathan Gleason
So just at Sonovan, if I am remembering correctly, he was married to a woman at one point. He did seem to have relationships with men as well. So he's kind of a perhaps bisexual, marginal or like, liminal character in this space. Yeah, he. He did, I believe, begin to identify as a gay man later in his life. But he was very private. He was very sort of laconic, really. It was only Michael Collin who could provoke sort of the emotion that, again, to the richness of this essay. But otherwise, you know, Sonovan was perfectly happy to kind of like live his private life, being a little bit prickly and a provocateur, but, you know, not always going to conferences, you know, putting out his papers, working with his patients. So, yeah, in some ways his sexual status is a little bit debated, but it seems like he, yeah. Had an interest in both men and women.
- [18:49]
Emily Dufton
Okay, thanks for that. So, you know, like we said before, your book covers a range of topics, but since this is a channel to devoted to drugs, addiction and recovery, I thought we could discuss essays that revolve specifically around those topics. So for drugs, as you just said, a difficult man discusses azt, which was an antiretroviral drug that seemed really promising at the beginning of the HIV epidemic. And in another essay that I also really loved, Gilead, you discussed the drug Truvada which is a pre exposure prophylaxis, also known as PrEP, that when taken correctly, can render an HIV infection undetectable. Can you tell us a bit about these two drugs and why you wanted to write about them?
- [19:38]
Jonathan Gleason
Yeah, definitely, yeah. PREP and azt, they have a lot of interesting echoes through history, which made me, I think, first interested in them. In some ways, I'm always interested in kind of echoes and correspondences. You know, PREP is kind of like a concept more than necessarily a drug. It's a pre exposure prophylaxis. At this point are a few different medications that can serve that purpose of preventing someone from contracting HIV when they are negative, but might come into contact with the virus. Truvada was the first big one, then descovy. Yeah. And then AZT was the first drug approved to treat HIV as an analog, basically meaning it replaces the nucleoside when the HIV virus goes to create its DNA strand and then the whole thing kind of unravels. Right. Unfortunately, like one big difference, although they have many echoes, is that AZT didn't really work. And PREP is incredibly effective and just responsibly, I feel like, have to note that. But in other ways they have a lot of similarities. You know, both of them made their manufacturers a lot of money. There are a lot of questions about access and getting these medications to the people who most need them. You know, in many ways PREP has become a lot more available. But when I was writing this essay and, well, when I was having These experiences in 2018 in Ohio, prep wasn't necessarily easy to get on. And so, yeah, I was very interested in exploring both of these medications in two different essays, but because they seem to speak to how problems, systemic problems, have persisted even as the context of HIV has changed and as the medications that we use to treat or prevent it have changed and we've come a long way. So that was kind of the big theoretical reason that I was interested in these two medications. But then I had personal reasons as well, especially in the essay about PREP and Truvada. You know, I had started seeing someone who was HIV positive. And of course, you know, for any gay man, AIDS is like a part of our lives. We think about it. You know, if you're a younger person, you kind of live in its shadow and in its history. Many people still alive, you know, lived through the acute period of the crisis. But this was really a moment where the stakes were made real. Both of like, HIV still being very relevant to my and other people's, but also the stakes of Getting on this medication. And it made me realize how much of my life could be mediated through pharmaceutical companies and through medical institutions and through whether I would get approved or not approved for this medication. And if I am going to be approved, how am I going to do it and how long is it going to take and how expensive is it going to be? And I had a relatively privileged position, so I can only imagine how much harder that is for other people. People. And then maybe even beyond that, I was really interested or, you know, those experiences made me aware of how much my own anxiety and fear, a lot of it created, understandably, from this acute period of the AIDS crisis, but that, you know, still exists today, even though the context of the illness has changed a lot, was preventing me from, you know, experiencing intimacy with that partner. And how much my own, like, internalized fe year was creating barriers that were both harming him and, frankly, harming myself. And even though I can definitely, like, empathize with that former self and understand why I was experiencing those anxieties, a theme that I pick up in a number of these different essays is like, how our medical anxiety really isolates us and can harm other people. So.
- [23:33]
Emily Dufton
Right. And these two drugs also really seem to kind of COVID the vast expanse of decades and scientific evolution that stand between, you know, the 80s and early 90s when AIDS was basically a death sentence. Right. I think I read a statistic where like 50% of HIV infected adults in, like, the early 90s were dead within 15 months. Right. It was very rapid and it was very devastating for, for a number of communities. But. And that's so different from today when drugs like Truvad and others and other forms of prep are relatively accessible and HIV can be rendered undetectable. So total transform. And I like the fact that you talk about. This book deals with so many queer themes and the questions and problems that have haunted your experience as a gay man in that lingering ongoing era of aids. But I love the idea that you can tell, essentially, a memoir through the development and accessibility of these two very significant drugs. And I really appreciated that. I think that's a way to show, as you say, that the biosystems that we exist in, the medical systems that we exist in, while they seem impersonal and they seem beyond the individual, they actually, actually have very, very individuated effects that you talk about openly and honestly. And I have to say I really appreciated that throughout the essays.
- [24:49]
Jonathan Gleason
Yeah, thank you. Yeah, absolutely. Things are changing so quickly, or they have changed so much since the 80s. And you're still changing. I joke a little bit that every once in a while, now that prep has become even more accessible. I read this essay, and I'm like, oh, it's a little quaint sometimes. Or it just reminds me that just in 2018, wow. The world was a very different place. We've been through a pandemic, but. But, like, with the HIV specifically even, like, things have really changed. Yeah. And a big goal of mine was to kind of acknowledge that, like, big sweep of history and try to pick up the threads that are, like, still with us.
- [25:24]
Emily Dufton
Totally, totally. And you do it well. So next I'd like to move on to essays about addiction. In Bitter Joy, you talk about a friend who seemed to struggle, or maybe not struggle at first with drugs, including opioids. And in no Harm, you talk about a doctor's controversial use of fentanyl for both medical and potentially lethal uses. Both of these essays are set in your home state of Ohio, and I think they give some really valuable insights into what drug use has become in that part of the country. So I'd love to hear your thoughts on these essays. What drew you to this subject matter? And why did you choose to portray it in the way that you did?
- [26:05]
Jonathan Gleason
Yeah, yeah, I talk about Ohio a lot. That's a surprising amount in these essays. Of course, it was a. You know, it's where I grew up. It was very formative, and I was living there, you know, in the. In the early 2000s, 2000s, kind of as the opioid crisis was really coming into public consciousness. It was in some ways peaking. And yet when that was happening, as, like, a young person, I wasn't necessarily aware of it. You know, the context was just opioids were sort of everywhere, seemingly overnight, all at once. But we. You know, it really made me aware of how some drugs get categorized as, like, dangerous and others get categorized as, like, medic medicine. That's useful. And of course, they kind of occupied both positions at the same time. We later, you know, came to learn that of course, you know, oxycontin and these. These other forms of opioids can be incredibly addictive. But because they were prescribed by doctors, they didn't seem as. As fearsome or as dangerous. You know, of course, now fentanyl is, like, synonymous with death in many ways. But in the essay, you know, no Harm Harm, it talks about kind of these. The use of these very high doses of fentanyl. There's no set limit federally, so we can't say that they're necessarily lethal doses. Because different people respond to them very differently. But people hear fentanyl and they think of stories that they've heard in the news. But fentanyl has really useful medical applications, sometimes really important applications. Not to throw another essay in the mix, but in the titular essay, I talk about having fentanyl administered as I'm going through this rib resectioning, you know, and it was a really necessary painkiller in that moment. And I think that's what makes a lot of these drugs difficult, is that they're incredibly useful, incredibly powerful, and also incredibly addictive. And that makes it such that we can't eliminate them completely. But also we have to be wary of their, like, profound capacity to create, you know, disability and even death, while they're also very useful tools. Yeah. And as for the essay Bitter Joy, the one about kind of growing up in the midst of the opioid crisis. Yeah. I talk about a friend who kind of slowly descended into heroin addiction addiction by way of, you know, opioids first. Yeah. And it didn't seem like a problem at first because, you know, we were young adolescents sometimes, you know, testing our limits. It wasn't uncommon for, you know, someone to. To have to, you know, a parent to have a minor surgery or someone to get their tonsils removed and have, like, a bottle of codeine in the medicine cabinet. And you just, you know, take some of it because you're sort of testing these limits. And it. I think looking at that essay, it really revealed to me how. How lucky we can be when we're not victims of addiction, because it is sort of randomly distributed. Who's going to, you know, fall prey to. At the same time that I was having those experiences, I was working as a landscaper with a bunch of people who were formerly incarcerated, many of them for drug crimes and addiction. And, you know, they came from kind of a socioeconomic status where maybe we would expect more rates of addiction. But my friend, you know, grew up in the same situation as me, very like, middle class. And it kind of reveals that no one is immune to these problems. They can affect everyone. They. The limits of addiction don't obey some kind of area code restriction. They're not limited to one area or the other. And the area where I was working as a landscaper wound up reappearing as a setting in the essay no Harm because it's a particularly impoverished area of Columbus. That is, for maybe understandable reasons, but I would say unfairly, often cast as a place with very high rates of addiction, where people just don't care about the neighborhood where there's a lot of crime, an unsafe area where you don't want to go. Certainly there are higher rates of, you know, addiction and poverty. But I know people who lived there as they were going through nursing school, and they were fine. They weren't victims of. Of addiction or any kind of crime. And the linking of this place to this expectation of addiction was also part of the reason that people did not at first pick up on how many patients in the essay no harm seemed to be dying from. From these very high levels of fentanyl. Yeah. I mean, that's one thing that's actually contested in that essay is whether the fentanyl administration was causing their deaths or whether they were dying naturally. These people were at the end of their life, they were on healthcare. But certainly it took a lot of instances of people dying under questionable circumstances before anyone took notice. And that seemed to be connected to this area's relationship to addiction. And also, it's just status as a more like, impoverished area of Columbus where the, you know, the public opinion is, oh, people there just don't care. Why would we think about this area? It's just kind of marginalized in the public imagination.
- [31:35]
Emily Dufton
Right, Right. Why bother? So, finally, I'd like to talk about your essays concerning recovery. You write at length about your own recovery, not from a drug addiction, but from the potentially lethal blood clot that we've discussed a few times in Field Guide to Falling Ill and from pts. I don't know if you would say you have recovered, but from your experience with PTSD and exit wounds, which was a really stunning essay as well. You also served as a medical interpreter in a clinic in Iowa City. Can you talk a little bit about the topic of recovery, both in terms of your own experience with it and also in terms of the patients that you translate for?
- [32:16]
Jonathan Gleason
Yeah, absolutely. I think. Yeah. I'm so glad you put those essays in conversation. Of course they're in the book, but I'm not sure that I've heard them linked before. But it's revealing to me that the insight I had to have into both of these essays was that the story was really about recovery, not about the event. The event was so acute and dramatic and seemed so, like, narratively rich. Oh, a blood clot is discovered. I have to rush to the hospital. They don't know what's going on. I. I have this sort of dramatic surgery in which a rib is removed to relieve pressure. Exit wounds. In that essay, you know, a man who was later revealed to be Having a psychotic br because he has schizophrenia, gets on a bus, tries to take it hostage, winds up being shot by police. Unfortunately, someone else on the bus was shot as well. Yeah. And both of those events, yeah, were. I wanted to write about them because they were hugely impactful in my life. But I struggled for a long time because I was very focused on the day of the bus being taken hostage in the shooting. I was very focused on the blood clot and the experience in the hospital, etc. And it really took me a while to realize that the real story here was, yes, that event, but then the recovery that unspooled after it. Because in both cases, it wasn't as simple as having a surgery or having an experience and then moving on from it. In the case of, you know, field Guide, the blood clot. Unfortunately, having this dramatic surgery didn't relieve all of my symptoms at once. I still sometimes experience them. It's likely that the clot is still there, smaller, less pressure, but might never completely go away. And so I spent months kind of having these worrying symptoms, feeling very betrayed by the surgeon in the medical institution and the hospital that had provided me care because they said I was going to recover. And then it wasn't as simple as that. And in Exit Wounds, I spent years kind of having sort of recurring PTSD events where I'd be kind of pulled back into the situation somewhat understandably. And in both cases, I kind of explore the context around the experience as I'm in the process of recovery. And in some ways, you know, it's a little mimetic of the experience. Right. As I. As I explore the context, it also helps me recover and the recovery becomes part of the essay itself. So, yeah, both of those essays are really, I think, the essays about recovery. Yeah. In terms of the patients, I translate for. Yeah. The Field Guide to Falling Ill, the essay is sort of a braided essay, or it has two parts. It's kind of me working as a medical interpreter at the same time that I'm having this. This medical crisis and dealing with the aftermath. For a long time, I thought these would be two distinct essays, but because they happened at the same time, I felt eventually like I just had to put them together and like they were working with one another. And the patients who I translated for at this free clinic, you know, we only treated people who didn't have. Who don't have medical insurance. So, yeah, generally these patients are impoverished. The patients that I worked with were all Spanish speakers. You know, we, of course, don't ask about Any kind of, you know, documentation status or anything. But you can imagine that some of them might have been undocumented. And so they were definitely dealing with accessing medication because of its expense, basically, and both getting treatment from my doctors because of its expense, and also just like being able to afford buying medication sometimes, you know, just for like, blood pressure or diabetes things, you have to take they after day. And that really revealed to me how much of medicine is not about enormous heroic surgeries. I mean, certainly that's a part of it. I kind of experienced one, and I experienced these big critical moments. But how much medicine is really about this active care and just showing up day after day providing like, small comforts and cheaper medications as often as you can. And I think in a lot of ways is that sort of my experience of recovering from both of these events and also figuring out that the structure of these essays was, yes, one critical kind of inciting incident, but really working my way through the process of recovering afterwards.
- [36:48]
Emily Dufton
So how did you become a medical interpreter? I'd imagine that you have to have a lot of familiarity with Spanish, especially like technical jargon, to serve in this job. So how did you acquire these remarkable skills? And what has serving as a medical interpreter meant to you?
- [37:06]
Jonathan Gleason
Yeah, I. Well, I lived in. In Santiago for a little over a year, which is where I really kind of laid my foundation of Spanish and then studied it for many years after that. When I moved to Iowa City to begin grad school, you know, I wanted to engage with the community in some way. I'd been given some really great advice, which is to find something to do in the city that isn't involved in writing, or writing will become the only thing you do. And we just had like, we could take classes across the university, and in fact, I think we had to as part of our degree. So I took a medical Spanish class, which was helpful. And they were just then, I believe, starting a program specifically for medical interpreting. You know, a series of classes you could take to kind of train in medical interpreting, its, you know, best practices, and including a lot of like, workshops on actually, like doing simulations to get good at interpreting. So I took those classes. I really enjoyed it. And the professor in one of those classes really encouraged us to, you know, then take these skills out into the world and use them. And so that's how I found the free clinic in Iowa City and why I started working there. And yes, of course, you have to be very familiar with medical jargon, though something interesting does happen with interpreting. Medical interpreting. One, like, at least you have a kind of defined system, set of complex terms that you have to learn. You're in the medical field, so you kind of know where to point your studies and your vocabulary, what direction to study in. And then also there's a lot of shared language in these specialized fields between English and Spanish and other language, which can be very helpful. There's also kind of a shared syntax of medicine, and I think any specialized field. I did some translation work, just informally for a friend who was working on a master's thesis and needed some documents translated into English about watersheds near the Rio Grande. And in helping him out with that work, I realized, oh, there's a syntax of academia that's really familiar to me, which made the translation a little bit easier. The words, of course, are different, but the pattern and the expectations and the sensibility were similar. And something like that, I think, happens in medicine, too. The hardest thing is always interpreting for the patients who come with a lot of very. You know, they come with their unique subjective experiences that you're trying to. To translate on the fly and get right and hit the right emotional tone. Thankfully, you don't have to come up with the words yourself, which is surprisingly like unburdening. You know, you're just there to replicate what they are saying, which actually, I think makes the work a bit easier. I find the hardest thing to be to be remembering, like, long strings of conversation as a patient is to trying. Trying to talk fluently, like with a doctor or fluidly with a doctor. Yeah, the memory can actually be the hardest thing. You'd be surprised at how few words you can actually retain and repeat verbatim even after you've just heard them. So it winds up being that language was a little less of a barrier, and it was that memory component, actually, that was one of the toughest things.
- [40:27]
Emily Dufton
Oh, I can imagine. Yeah. Having to repeat, to listen to what someone is saying, translate it in your mind, and then speak it to another person in an alternative language. It has to be hugely draining, but great for you for doing it. And I love that the University of Iowa is pushing you to do something other than writing so you don't lose your entire life over it. But that actually, it kind of plays into my next question because you said in your acknowledgments that this book took about 10 years to write. So obviously this is some real investment. And you can see that in the braided nature of these essays and how beautifully thought through they are. So how do you feel about it being finally released into the world. And what do you hope these essays will achieve?
- [41:13]
Jonathan Gleason
Yeah, I mean, I feel great and accomplished and, you know, a little bit anxious and scared because suddenly this thing you have sort of total control over. And, you know, I think everyone imagines their book will someday be out in the world, but sometimes it's hard to. To really picture that and know what it's going to feel like. Suddenly it's there, it's printed, it's unchangeable. It's going to go out in the world and be sort of at the mercy of people's, like, judgments and interpretations. And that's always a little bit scary. But why?
- [41:42]
Emily Dufton
What's terrifying about that? I don't understand. No, I'm.
- [41:45]
Jonathan Gleason
Yeah, yeah. I think anyone who's created anything, like, has that moment of like, oh, wow, it's suddenly real. I'm suddenly releasing it. Can't. Can't really change it anymore now. But, you know, mostly I'm really happy and excited for it to be out in the world. I hope that, you know, it equips people to like, walk, like practically to come to medical institutions, you know, just better equipped to understand, like, the history and context that precedes them, I think. So often, you know, I walk into a doctor's office and feel like I'm there alone, kind of loosed from any history or context. Just having this one off interaction with this institution and writing this book helped me see, and I hope it helps other people see that that's not really the case at all. Like, we arrived to these moments out of history and knowing that can, you know, might maybe make people more aware of that situation. But I think maybe more generally it just makes us aware that any time we're interacting with an institution, there's a history behind it and there's a reason things have come to be the way they are and they are on ultimately changeable, hopefully for the better in the future. And all of these essays are anchored in personal stories and human relationships. And I hope that that makes people feel less alone when they have these experiences, sometimes scary experiences with medicine that can be really isolating. I quote John Donne in one of the essays, actually the one that also contains the reference to Greg Luganis, which he talks about the greatest punishment of sickness being solitude, which is not even threatened in hell. And yeah, I mean, being sick can be very isolating, I find. And yeah, I hope that this book makes people feel less alone, even in their sicknesses.
- [43:40]
Emily Dufton
That's beautiful. I know. This is like asking someone to name their favorite child or their favorite pet or whatever. But as I said, my favorite essay in this collection was A Difficult Man. And I'd love to name know which essay is your favorite in your collection?
- [43:56]
Jonathan Gleason
Yeah, that's a great question. It. It certainly cycles and is. Is hard to choose. I think. I think it might be Blood in the water, the 1. The essay structure that has letters to Gaetan Du Gas. I just felt like that was really a moment where both the. The personal experiences and the history and the form all really combined to create something that was greater than the sum of their parts. You know, this. This essay is structured as letters to Gaetan Dugas, you know, the man who was falsely labeled Patient Zero, the man who gave us AIDS in North America. This wasn't true. And in many ways, he never got to see what became of his legacy because he died so early in the crisis. And so the letters really allowed me to speak directly to him, to create this kind of intimacy without, I hope, like, crossing over this line into, you know, inventing sensations and experiences and thoughts that he would have had and that we just really can't know about. You know, I tried to learn as much about him as possible, but with historical figures, sometimes there are just limitations.
- [45:03]
Emily Dufton
Totally. I liked that essay a lot too. That's a great choice.
- [45:06]
Jonathan Gleason
Yeah. But I am very glad you liked A Difficult Man. Like I said, I considered maybe not including it, but I'm glad you did. Yeah, me too. In future projects, I think might have a similar bent to them, and it's definitely something I'm exploring.
- [45:19]
Emily Dufton
Nice. Finally, could you explain your choice of Marc Doughty's poem Charlie Howard's Descent as your epigraph?
- [45:27]
Jonathan Gleason
Yeah, absolutely. Yeah. Charlie Howard's Descent, a beautiful poem by Mark Doughty from Turtle Swan, I believe, his first collection, and then later collected in Fire to Fire. Yeah, I love this poem. It's about. It's kind of a historical narrative poem about Charlie Howard, a man who was thrown off of a bridge in an act of, like, you know, violent homophobia and died because he couldn't swim. In the poem, Doty imagines sort of Howard falling and then, you know, the ghost or spirit of him, like, climbing back up and sort of forgiving his attackers. And he says, as only the dead can forgive. I don't quote the entire poem, though. It's a beautiful one that I encourage people to read.
- [46:14]
Emily Dufton
I.
- [46:14]
Jonathan Gleason
But I liked this image of how coward as a diver with only an edge of fear, that he transforms into grace. That's the quote that I use And I felt like, you know, all of the sort of underlying subtextual themes in these essays, one of the biggest ones was fear. What it can do to us, but how we can also overcome it and turn it into a kind of grace, a kind of enlightening, a kind of self discovery, how we can acknowledge it, move past it and become something better because of it. And I think the poem engages with that. And that specific epigraph kind of felt like the right sliver to take out of the poem and use in my book. Also, the image kind of relates to Greg Luganis, this famous athletic figure who was really formative in my understanding of my own queerness that also though linked that queerness to HIV and aids because I kind of learned about him at the same moment that I learned about the virus. And those two things became entangled and.
- [47:21]
Emily Dufton
Complicated, but in a beautiful and compelling way. That's fantastic. Wow. I really appreciate the selection from Mark Doughty's poem even more, though. Thank you so much for that. Well, I really just want to take you. I just want to thank you for taking the time to talk with us today. Your essays are beautiful. I learned so much from reading them. And I hope that others have that experience of feeling less isolated, less alone, and also more aware of the systems that they enter themselves into when we participate in America's healthcare crisis. So now I'll ask you our traditional last question here on New Books Network, which is what are you working on now and what can we expect to talk about you talk about with you next?
- [48:03]
Jonathan Gleason
Yeah, that's a great question. You know, I haven't fully settled on a next final project, but I think the front runner right now is a collection of ess. Maybe it won't take the form of a collection of essays, but a book about three doctors in the early 20th century who both shaped medicine in some way while also shaping queer identities that we now sort of take for granted as like stable and solid, but were very much in flux at the time. So, you know, Hirschfeld and Alan Hart and Sarah Josephine Baker are the three people that I'm looking at specifically. Haven't decided exactly if those will be the only characters in this book. But yeah, I'm doing a lot of the deep kind of historical research that maybe you saw in A Difficult man and trying to explore how their self conceptions and their internal worlds shaped both the way they navigated the world, the way they practice medicine, and the way in turn their practice of medicine kind of started to lay the groundwork and solidify what we now write, recognize as these clear queer identities of like, gay and lesbian and trans. Yeah. Which, which weren't always a given, right. That they would arrive to us in this form. And medical institutions had a big part in shaping and solidifying these identities in a, you know, complicated way. Medical institutions weren't always kind to queer people, but queer people also kind of learned to use them to their benefit. And so, yeah, this, this book, I hope to explore a lot of those themes and really enliven these characters and kind of, you know, breathe, breathe this sort of like vitality back into them through like, narrative and exploring what the interior of their minds might have looked like during these periods.
- [49:58]
Emily Dufton
It sounds fascinating and I can't wait to read it when it's finally out in the world. In the meantime, where can people find you? Do you have a website? Do you have a social media page? Where can readers find Jonathan Gleason and his work?
- [50:12]
Jonathan Gleason
Yeah, absolutely. Yeah, I have a website, Jonathan Gleason.com, really easy to find and that links to pretty much everything. But I also have a substack where I write about some more like topical themes in medicine, things that are in the news, things that maybe don't quite achieve the level of an essay that I want to work on for months, if not years, but that does have some kind of connection to history and politics and culture. It's called Histories of present Illness. Those are probably the best places to find me.
- [50:42]
Emily Dufton
Excellent. Well, we will link to both of those in the show notes. Well, I wanted to take this moment to thank you so much again. Field Guide to Falling Ill is out now from Yale University Press and Jonathan Gleason. This has been an enlightening and very enjoyable discussion. Thank you so much.
- [50:59]
Jonathan Gleason
Yeah, thank you.
- [51:13]
Emily Dufton
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