Iatrogenic: Their Testimonies by Danielle Pafunda
Noemi Press, 2010
Review by Kristin Abraham
I have been a fan of Danielle Pafunda ever since I read her book Pretty Young Thing (Soft Skull Press 2005), but I have to admit that I was loathe to read Iatrogenic at first. I was torn between loving Pafunda’s poetry and feeling absolutely turned off by the title of her latest book. The word iatrogenic is, well, ugly. And although the Their Testimonies part of the title intrigued me, I wasn’t sure that would be enough to get me past the other word.
I didn’t know what iatrogenic meant, and I convinced myself—in some lame attempt to excuse myself from actually looking up the word in the dictionary—that Pafunda had made it up. This notion of which I had become convinced deterred me even more from reading the book. Ultimately, though, the draw that I felt toward Pafunda’s poetry, which has never let me down, enticed me to read Iatrogenic.
I finally, reluctantly, did look up the word, but not until after I read the volume in its entirety, which I think ultimately had a very interesting and positive effect on my reading experience. My first read, then, was driven / affected only by the Their Testimonies implications in the title, and even without a complete understanding of the title, I was utterly blown away by Pafunda’s unique use of language and creation of a kind of science-fiction world that I have never before seen in poetry.
What follows separates my impressions of the book in a kind of “before-iatrogenic” and “after-iatrogenic” scenario because I encourage others to read the book in this manner.
Upon reading the first poem “Wherein Proliferation Is Explained to the Surrogates,” I was immediately reeling (in the best possible way—after all, isn’t that what good poetry should do, make us reel?). It was clear that Danielle Pafunda had not only not let me down, but she had exceeded my expectations.
From the first poem, this book becomes a journey to a world unlike any a poet has ever presented; the collection presents a science-fiction reality slightly familiar to us, yet disarmingly strange and much more unfamiliar than it is familiar:
They tell us the cells will enter our reaches. From one
to another of our organs, lighting the succession
with their own gruel matter. Silt the perimeter, trench
the wire. From then on, they say, we will be free
from solitude. We will keep time with our own beating packets.
We can assume that this poem discusses surrogacy in the sense with which we’re all familiar; that is, a surrogate mother, a woman in whom an embryo is implanted at the behest of another woman who can’t bear children. Yet Pafunda’s language is just off-kilter enough to make us question whether this is a “traditional” surrogacy; we begin to ask why these cells are traveling among organs and not restricted to the uterus, and what exactly a “beating packet” is. Could it merely be another heart and nothing more?
“Packet” implies something a bit more sinister, less human than “heart.” So, too, we find other descriptions that are sinister and inhuman: “Where does it sting? she asked me. // And I answered her in my deck.” These lines turn the sting on readers; Pafunda adapts words, twists them into alien configurations to make us feel, even if we don’t understand what they mean. The sting from her language affects us physically, but to point to one particular location of the body where we feel the poetry would be futile. Physical-emotional feeling produced by a poem is everywhere at once, though we rarely stop to think about its location; Pafunda’s use of the word “deck” in this instance decentralizes meaning and subverts our expectations of bodily sensation enough to make us consciously acknowledge the sting is everywhere. “Deck” itself cannot be one particular location on our bodies so by naming it, the poet pushes us to investigate a sensation, as opposed to its location; or, rather, she pushes us to investigate locale of feeling in general, as opposed to making a futile attempt at finding a centralized, specific source—it is, she points out, impossible.
In the poem “Wherein a Surrogate’s Fixing” we find even more subversive language in the form of strange mixed with familiar. We often find ourselves in what seems to be a hospital / medical scene, but in a room / department in a hospital unlike any we’ve ever been to:
In the stitchery, where they’d removed her, first one ocular X
then the next. It was custom, they said. They darned the body pocket.
All this for the ash can. But it must mete out in order. First
the craggy thread, then the glaze. In her palm, they embedded
twelve daubs. Mercury, marcasite, graphite, geranium. They slit
her heel to calf, anticubital flaring. Spread and flecked. A wisened
caramel. Her pores were close, her nostrils plugged. They wound
her hair around the gibbous spindle.
Suddenly, we’ve “left that world, trailing the rope-worn melody” of a scene we thought we were somewhat familiar with. “They” don’t sound like doctors anymore, and what they’re doing isn’t exactly what we would consider medical. It sounds medical, but combined with such non-medical language as “mercury, marcasite…geranium” and “caramel,” and customarily “darned…body pocket[s]” the poem leaves us unsettled and squirming in our seats. Pafunda makes even ordinary words, such as “caramel,” utterly disturbing and even frightening, when placed in unordinary juxtapositions. The surrogates she describes are thus part of scenes both threatening and fear-provoking, scenes which only happen in scary movies and our bad dreams: bodies with threads x-ed over the eyes, nostrils plugged with cotton, glazed over and embalmed.
If you’ve read Margaret Atwood’s The Handmaid’s Tale, it won’t take you long to compare Pafunda’s bizarre surrogate condition to Atwood’s disconcerting handmaid condition. The characters and their worlds are parallels.
Pafunda’s Iatrogenic is a world in which the “surrogate” is held captive in her “paper tog” and “printed anklet,” where she “rub[s] [her] skin / with oleo and [wears] a gown of egg white.” Unlike surrogates we are familiar with, this poet’s surrogates are not willing participants in their “medical” procedures; they are forever being acted upon, and unless “scaling the wall,” or “en route,” escaping, they can only be perceived as victims: “When the artifact came to skim my cavity, I was, / they said, to follow the protocol. To respond I / am well and to ask no questions….”
With a poetic flick of the wrist, a subtle verb here and there, Pafunda indicates quite skillfully and without ever stating outright, the surrogates are prisoners being acted upon with very little power over their own external realities. Their internal voices are free only through the surrogate voice of “poem.”
Thus, the poems in Iatrogenic are not only vehicles for the creation of an eerie Atwood-ian world, they are surrogate voices for strong-yet-oppressed women. Pafunda demonstrates a fine-tuned ability to channel these women’s voices as first-person epitaphs in a delightfully unique hybrid of such writers as Charlotte Perkins Gillman and Edgar Lee Masters.
In the middle of her unnerving science-fiction world, we are simultaneously launched into a kind of feminist Spoon River Anthology of resilient female persona poems: Gilda Maer, Anne Frank, Emma Goldman, Catherine the Great, Calamity Jane, and Kateri Tekakwitha (a Mohawk-Algonquian who converted to Christianity and was later made a saint by the Roman Catholic Church), to name a few.
The voices are strong, sometimes humorous, and always with at least a touch of defiance. Take, for instance, the poem “Who Chose Zsa Zsa and Eva Gabor,” where Pafunda adapts her voice to be that of twins, misunderstood and misappropriated by the eyes of the world, worn down to nothing, yet cunning survivors nonetheless:
In the green enamel basin, so round as
to appear impossibly sterile, they’d later
find our watered down. And islands
of fat wrecking the fluid. Scream, sure.
But wasn’t it the best donation either
one of us could conceive?
Through each of her surrogate poems, Pafunda maintains an overarching use of syle and language—that strange decentralization and subversion of meaning, especially when referring to the physical body—which creates a binding thread among the poems and pulls them together into a highly cohesive volume, a poetic “beating packet”:
Fringed parasol, I tucked my charcoal lengthwise.
The thin plastic lung proceeded. Its albescent
wiles. Regarding the message, my handwritten
assent. But in the gloaming I could only manage
Despite the scant regret unfolding. As the fingers,
the people under the church, and its steeple.
Ultimately, Their Testimonies are vivid, intoxicating, and forever disturbing, poems which will be nearly impossible for a reader to forget.
SPOILER ALERT: As I have already indicated, I believe my reading of Pafunda’s poetry was actually enhanced by not learning the meaning of that ugly word, iatrogenic, until I had read and gained an initial appreciation for the book. Ignorance wasn’t necessarily bliss, but it created more layers of meaning, which I was able to consciously watch myself build once I decided to use a dictionary at the end of my initial reading. Thus, I encourage you to try it yourself: read the book before you figure out the meaning of its title (unless, of course, you already know the definition). If, however, you are not one to maintain your curiosity, and simply must know how that word influences the title and the book itself, I will now discuss that dreaded, ugly word iatrogenic.
Lo and behold, of course I found that iatrogenic is a “real” word, with a “real” definition. Iatrogenic is an adjective used in describing a medical condition caused, inadvertently, by a doctor’s treatment, most often—but not limited to—treatment with a drug or prescription. Interestingly enough, iatrogenic illnesses may also be caused simply by something a doctor says, or by the way s/he touches or acts around a patient.
As represented most clearly in her testimonial persona poems from a variety of prominent female figures, Pafunda translates the iatrogenic emotional condition indicated in every woman who has ever been violated by the way another person speaks about her or around her, by the way another person touches her, or by the way another person “diagnoses” or interprets her. The poems in this book offer a voice for a general female condition, a recourse for “guilt’s own tanned hide,” and a way to undo what has been done.
To re-read Their Testimonies in light of an Iatrogenic adjective does not alter the meaning or impact of Pafunda’s poems; rather, the impact is greatly enhanced. The doctors and midwives in these poems implant their surrogates intentionally and physically, but in light of the severe duress they inscribe onto the patients’ bodies, they inevitably—although inadvertently—cause emotional stress:
I had been napping. They took from the peg the key and digit.
My skin rolled back, my snap. Window, they said.
Slide, they said. And the package was secured to my rib
with a length of cable and a clove hitch.
To awaken from a nap, whether metaphorical or actual, to such imposition on the body is a terrifying premise, especially for females whose bodies have been traditionally more easily overpowered, maneuvered and / or interpreted against their wills. Scenes such as this evoke images of rape and other abuses of physical and political power, which is primarily and historically a female concern / dread.
Such abuses are never only physical; the dread and helplessness they can produce always affects the victim emotionally, often long after escape from any initial and / or physical pain: “I took to the duct, and later to the slate path. And / I took their fondling with me.”
In the end, what is most important to recognize is that the poems in Iatrogenic: Their Testimonies are not a “woe-is-me,” “look-what-they’ve-done-to-me” pretext; they are a celebration of strength, vindication, and defiant reclamation of voice and identity:
In that world I was never without my spine.
I carried it at an angle, counterbalanced. I swam,
spine aloft in the mayflies’ tin havoc. Who
said to me, you better link? Who said foul-
tempered heron, desist?
No matter. I cramped each bend and not a line
in the sand, not a grain in my macular hole.
One could’ve held me up to the light and through
pleated ovations realized.
Just as the Emma Goldman persona, so all of these women—named and unnamed, real and surrogate—can be held up to the light like eggs; there we will see a ramrod spine, a flexible tensile strength that will never be violated. In this book, Danielle Pafunda celebrates women and their spines, but also their whole bodies, especially the parts of their bodies which make them female, which may have been violated:
Beak, box pursed. Clam creased, estuary articulate, apiary
of gadfly and hormone. My jaws, my kisser, my portal.
My roam. Rim, trap, yap. Is it not fine, the barbed burr,
the metal rye singed and hardly a flick of hospice? Not
fine. But ours default. Your rich case, your warm shuck.
The book ends in an unforgettable and most contemporary poetic celebration, a kind of “Ode to My Uterus,” but—if possible—an even more updated version of feminism: ode to the vulva. Pafunda’s poem seems somehow more appropriate for the 21st century, a celebration of what can be seen with the “plural eye,” what is the visible evidence of physical femininity which is often mis-seen and abused by our ever-vigilant and ever-interpreting world. The testimonies in Pafunda’s book are evidence of the iatrogenic—what occurred in the past—but this final poem “In a Glade,” seems to seek / speak toward a possible present and a definite future, because “there is no such starting over.”
Iatrogenic: Their Testimonies is surely the beginning of a new kind of feminist poetic politics, presenting us with a world that may not be as “science fiction” as it may seem at first glance, and offering us a voice that is not reduced to one single emotional reality but comprised of multiple attitudes, realities and personas.