Are Medical Mysteries the New True Crime?
I don't think so?: A bonus mini-newsletter in which I gripe
This response was originally a Note1 but as I entered my second paragraph and first block quote I realized it made more sense to make it a mini-newsletter2 instead. I’ll be sending out a piece that doesn’t give so much “narcissism of small differences” tomorrow.
It all began with the excellent Lit Hub Daily newsletter (subscribe here! CrimeReads is great too!) that linked to a New Republic article with the query: Are medical mysteries the new true crime?
A (intentionally, no doubt) provocative claim that certainly earned my click. And I was a bit surprised to find myself at an article with a title that went ahead and answered in the affirmative!
But I don’t think this definitional argument quite works. Are medical mysteries like detective or even crime fiction? I find that idea persuasive, and even illuminating in terms of how to conceptualize a body that is both victim, detective, and crime scene. However, I think it’s important to if not police, at least explore, the generic border between true crime and crime fiction and detective fiction (it’s my whole newsletter’s raison d’etre after all!).
Cummings includes examples of excellent medical memoirs, and I think it’s telling that in almost every case, she includes reference to crime fiction, not true crime, as evidence:
Cheryl Strayed has observed that Porochista Khakpour’s 2018 Sick—her account of life with chronic Lyme—“reads like a mystery.” In her 2021 book, The Lady’s Handbook for Her Mysterious Illness, Sarah Ramey writes that she “Miss Marpled for my life” after a botched procedure left her “undead.” In her new book A Matter of Appearance, Emily Wells likens her body to an “escape room” she can’t quite solve. Allison Behringer’s confessional, critically acclaimed podcast Bodies (tagline: “a show about people solving the mysteries of their bodies”) is now in its fourth season.
As I was reading, I was thinking about the elements of true crime that I find most important and politically urgent: talking about violence against individual bodies to expose and dismantle systemic injustices. And even though the broken healthcare system in America is not (technically) committing crimes in the legal sense,3 I could see an analysis in which these medical mystery narratives are also about how the medical-industrial complex is making people sicker by and through producing ill bodies that require ever increasing, mystifying, and costly procedures to treat.
But that’s not quite what Cummings is suggesting here. And I think it’s her concluding definitional argument that I want to push back on:
Like true crime, the patient memoir seeks to impose a logic on a world teeming with violence. A good narrative—whether shared in a book or between friends—can restore some semblance of order on a life that has ceased to make sense.
And my thing is, I don’t think that is exactly what true crime does.4 At least not the true crime I find most compelling and politically actionable. Texts like The Red Parts: Autobiography of a Trial and The Third Rainbow Girl leave the reader without any sense of a logical resolution to misogynistic violence. James Baldwin’s masterful book-length essay on the Atlanta Child Murders insists upon the lack of logic in Atlanta’s racist police force when investigating the crimes. Even the ur-podcast Serial famously ends on questions, not answers.
And I think this is the real point of thinking through what is or is not true crime: what does it have the capacity to do in a world that is “teeming with violence” against real bodies? How can it disrupt larger social systems that put marginalized people at risk over and above the fragility of all our bodies? I’m willing to invite medical mystery memoirs to the party, especially since so many of them are written by women who are too often placed in the position of advocating for their own lives when they are at their most vulnerable.
Which brings me to my last gripe: Nearly all of the authors Cummings mentions are white.5 BIPOC women experience discrimination and worse outcomes in almost every measurable metric in the healthcare system.6 Their voices, even if they don't fit neatly into the "medical mystery memoir" box, must be included in any argument about the criminal ways medicine underserves women.
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It ended up being not so mini.
Except in cases of medical malpractice, criminal negligence, or civil settlements against liable corporations or families like the Sacklers. For example, I think of Erin Brockovich’s memoir as true crime adjacent, and the film crime fiction.
Imposing order on a chaotic world is a workable, though often dismantled, definition for, again, the plots of detective fiction.
With the sole exception, I believe, of Porochista Khakpour.