The Sanatorial #2 – Rouzbeh Shadpey
A monthly Q&A on illness & practice
Welcome to The Sanatorial, a monthly Q&A with an artist or writer about fantasies of the sanatorium and the relationship between illness and practice.
‘—I’m tired, this wretched expression, is a sick person’s love letter to desire’ writes Rouzbeh Shadpey in In Defense of Indefensible Expressions: On the Pure Complaint of Chronic Fatigue. Shadpey’s elegant discussion of this insufficient phrase spoke to me deeply. It is uttered by the sick person a hundred times a day, in an attempt – with all the success of catching shadows – to give form and presence to a life-sucking fatigue. That I’m tired never manages to convey this does not seem to deter its utterance, nor does its ubiquity; as Shadpey puts it, ‘To say one is tired, in the current era of normalized capitalist burnout, unending genocide, and planetary exhaustion, is to say nothing but the obvious’. We might hear its repetition by the sick, therefore, not as a demand, but as an act of ‘pure complaint’ which grounds its speaker in desire: ‘[...] to say one is tired is the equivalent of saying I am not now how I want to be now, which is none other than the distilled expression of desire; to want something else, which is just to say, to want.’ In this essay and elsewhere, across writing, sound, performance and visual practice, Shadpey’s work takes the ‘bad language’ of chronic fatigue as its subject. It’s both linguistically and theoretically playful, and metabolises Shadpey’s medical training to forge an expansive ‘poetics of weariness’ from inadequate medicalised concepts and terminology. This is like methodological catnip to me, and in trying to think through the language and experience of fatigue, Shadpey’s work has been a source of high pleasure and deep sustenance. If you like the sound of this but I’m tired, you can also listen to this excellent conversation between Rouzbeh and Emily Lim Rodgers for Red Medicine, recorded earlier this year.
– DL
Your ideal sanatorium
I became sick the year before COVID, and I distinctly remember my perverse satisfaction at this improbable exteriorization of my bodily restraints. The physiological injunction to quarantine turned state order—world order: freshly disabled, this fucked with my psyche. As if my outrage at the injustice of becoming disabled—why me!—had translated from fantasy into punishing reality. Bizarre…
Now, many disabled people have hinted at the business-as-usual quality of life under quarantine. Of course, quarantine was also a luxury unafforded to the racialized workers, unworthy of narrative, who kept the halls of the sanatorium clean for its patients. I’m not sure why your question of the ideal sanatorium conjured this memory of quarantine in me, except perhaps to underscore the synchrony I yearn for between the individualized subject of illness and the outside that excludes them. A few years ago, I wrote a review-essay about the artist Leila Hekmat’s exhibition Female Remedy—“A facility for an illness which requires no treatment. A Malady for which there is no cure”—to which I gave the title “A Clinic the Size of the World.” I think my ideal sanatorium would be the world. More concretely, it would probably lie on the Mediterranean coast.
A typical day when you’re not flaring - A typical day when you’re flaring - Relationship between your condition and your practice
One of this illness’ greatest challenges has been relinquishing the notion of a typical day—whether sick or healthy, flaring or not. There’s a radical contingency that chronic fatigue has introduced in my life—made of my life—where I cannot predict what my capacity will be tomorrow, let alone in the next hour. This makes stable work and commitments difficult to hold. It also makes research, thinking and writing tough. I’ll be in the middle of a piece or thought when a multiday flare up will bring me to a sudden halt. Theoretically, I try to formalize this interruption; incorporate its fragmentation as a formal constraint. But pragmatically, it really just sucks. Unsutured thoughts dehiscing at the edges.
Still pragmatically, what this has meant is that I try to give myself time and stillness when I’m working, lest the symptoms make it impossible. So I’m either working or living—which includes fucking, socializing, exercising, eating well, etc. I suppose this dichotomy applies to most under capitalism, disabled or not, but I feel its schism quite violently. Nevertheless, I’m grateful to have the financial security to spend my fistful of “healthy” hours each week doing what I love.
Also: shoutout to podcasts and audiobooks. I know they get a bad rep, but in the midst of a flare, they’re often my most faithful companions. Some years ago, my therapist tried to convince me that I was a masochist for listening to theory lectures while in the throes of multiday migraines. This cemented my suspicion of his anti-intellectualism—and of the profession’s writ large.
Relationship to diagnosis
Very fraught: I write about this a lot. It might be the thing I write about the most. I often find myself mimicking airquotes when I tell people I have chronic fatigue syndrome, not because of internalized ableism or a disbelief in the condition, but because I find the signifier so silly. Chronic fatigue syndrome—is this not but a perverse tautology? These three words literally mean the exact same thing, so why string them together? I’m also wary of its twinned signifier, myalgic encephalomyelitis, with its air of biopathophysiological authority. The truth is, much of my disdain for this diagnosis stems from my medical background, and understanding how for all intents and purposes, ME/CFS functions as a diagnosis of exclusion within biomedicine, which is to say, a diagnosis predicated on ruling out all other diagnoses.
The other thing is: I truly believe there is a radicality to the concept of fatigue, its symptom, that challenges the very foundation of the Western biomedical clinic—predicated as it is on the sick subject’s Cartesian split into objectifiable flesh and subjective psyche, as well as the circumscription of “organic” health from larger social questions of food, housing, and economic security. The folks at Death Panel do a valiant job reminding us there can be no health under capitalism. Well, turns out that fatigue has, since its modern scientific inception, stoked the deepest anxieties of capitalists. Anson Rabinbach’s The Human Motor is an unparalleled survey of this genealogy. I’ve also written about the theoretical shift that chronic fatigue demands of us in order to conceptualize it, given that its fatigue is untethered from both the expenditure of work/energy and the replenishing promise of rest/repose.
Ultimately, one can’t escape diagnosis—whether materially, because of gatekept access to insurance and benefits, or symbolically, because of the existential necessity to name suffering. Symbolically, I think an ill-fitting signifier can do more harm than a missing one. If the clinic were not so hell-bent on disavowing its castration, we might begin to articulate a grammar of illness secure enough to remain open, undefined. The hasty judgment, There’s nothing wrong with you—or its more authoritative foil, ME/CFS—might then give way to humility: We don’t know what you are suffering from, but you are suffering. Gillian Rose renders this critique in predictably acerbic fashion: “I perceive all the more pellucidly the subliminal beat: what you cannot cure, you condemn, so that you restore the equilibrium of your dangerous inner impulses.” To withstand the clinic’s dangerous impulses is the agon of biomedicine’s outliers: its poor, racialized, gendered subjects; its hysterics, malingerers, and Munchausens; its psychosomatic subjects of contested illness…
The metaphor or analogy most often invoked to explain your condition
Fatigue remains for me the greatest metaphor. Unlike Sontag, I relish in this. I don’t have much of a choice but to: I have no evidence of my condition other than the words I wield. I think I expressed to you, Daisy, how touched I was by your desire, expressed in Lovebug, for metaphors that do justice. It reminded me of John Forrester’s description of the aim of psychoanalysis: “to restore to metaphors their metaphoricity: their ability to carry.”
Rouzbeh Shadpey is an artist, writer, and musician with a doctorate in medicine and indefatigable fatigue. He lives in the Netherlands.