[11:11 Press; 2023]

“She wanted to die and I wanted her to live and we were enemies who loved each other.”

—Miriam Toews, All My Puny Sorrows

A few months back, I visited the Bay Area for a friend’s birthday. Beth was eager to hear what I thought of one of her favorite books, which I excitedly told her I’d finally read. I stood washing dishes at her little house in Oakland as she enthusiastically asked for my take. I watched the water slip around my fingers and down the drain. Time slumped; I couldn’t remember a single thing. It took digging through the recesses of my brain to remember that there was something about sisters. I gave a vague, near non-response. It took prodding to even remember the basic plot point of one of the sisters’ suicidality. Beth pushed on, articulating her admiration of a story so tender toward someone who so seriously wanted to die. Slowly, the book, and my experience of it, resurfaced. I remembered my nearly opposite experience reading this book which had dragged me, as if through slime, into the depths of someone’s relentless pursuit of death. I had not responded to the book’s empathy with any of my own—I had been annoyed. I told Beth that I supposed something about my mom’s suicide had hardened me—that I had, in fact, spent over two-thirds of my life cultivating an ethic and identity against suicide, perhaps to the point that I couldn’t even retain the plot of a novel that got up so close to its ugliness and still stayed kind toward it. While I’ve long considered myself an avid supporter of physician-assisted suicide, I was deeply challenged by the idea that terminal illness might not be the only reasonable justification for “death with dignity.”

It wasn’t long after my visit to the Bay that I read Vi Khi Nao’s Suicide: The Autoimmune Disorder of the Psyche, which is Nao’s own account of living despite chronic suicidal ideation. Familiar as I think I am with suicide, I did not expect such a challenge. Just two pages in, Nao writes, “Unlike Virginia Woolf, my least favorite way to die is drowning. Placing pebbles and heavy rocks in her coat’s pockets was actually poetic. (It demonstrated her potential intimacy with Samuel Beckett.) But I am not that poetic.” Like Virginia Woolf, my mom drowned herself with the help of pebbles and rocks. I have spent the last twenty-three years contemplating these poetics, and by every measure they inform my own. Not infrequently, the gap between myself and Nao felt unbridgeable. I might have argued that it’s a form of love (however paternalistic) that spawns my impulse to reject Nao. A fool might think (and surely I did), that there is no narrator more unreliable than a suicidal one—one who might at any moment stop telling the story. But Nao kept breaking down my desire to reject her as I had Elfriede of All My Puny Sorrows, and more seriously, my own mother.

Suicide: The Autoimmune Disorder of the Psyche is brutal—so brutal that one wonders how its author survived to write it. As much an exploration of chronic pain as it is of suicide, the book chronicles a life defined by ceaseless physical pain. (Autoimmunity here is not just figurative—Nao has a thyroid autoimmune disorder.) Of her heart condition, Nao writes, “The door of my mitral valve in my left ventricle had deteriorated completely and it was, painfully, making me hard to exist.” Making me hard to exist. For Nao, suicidal ideation is not something that arises arbitrarily. Conditions create it. Suicide chronicles these conditions: intergenerational trauma, migration and diaspora, queer experience, religious devotion, mental illness, and more. Nao’s preoccupation with suicide is inextricable from her mother’s (“my mother has always been suicidal and wishes to exit life early”); her mother’s is inextricable from the conditions forcing her flight from Vietnam. Similarly, Nao’s suicidality can’t be separated from her experience growing up gay in the Vietnamese Catholic community to which her father fanatically subscribed. Nao writes, “Christianity is a dominant force for imposing social guilt and social torture . . .  the world is a cruel place to be,” making me hard to exist.

Indeed, Suicide presents a scathing critique of the structural forces giving rise to suicides. Among the innumerable tangents taken by Nao is the story of four teenage boys arrested for burglary and animal cruelty after breaking into a Foster Farms poultry facility and mutilating nearly a thousand chickens with golf clubs. Nao responds,

We don’t earn the right to call these boys insane. They are not insane. They are not a product of our fantasy or imagination. They are us. We can’t simply incarcerate or institutionalize them to absolve ourselves of our current crime. We can’t stash, detain, confine a mirror (those four mirrors) and call it insane. They offer the most accurate reflection of our humanity.

Similarly, we can’t dismiss those who respond to the violent conditions of global capitalism, imperialism, and environmental destruction with suicidal ideation, or attempted or completed suicide. They are our mirror; they are us.

Formally, Suicide: The Autoimmune Disorder of the Psyche is as confounding as suicide itself. Nao anchors each paragraph with a digit of pi—that mysterious, irrational number that forms the key to every circle. Ninety-something pages of prose are followed by some fifty more pages filled with further digits of pi, ending abruptly, at a mere fraction of the 31.4-something trillion digits on record. This playful exploration of the irrational serves as a powerful slate for what might be Nao’s thesis: “It’s very simple: I am pro-suicide because I am anti-pain.”

Nao elucidates suicidal thinking as a rational coping mechanism in an irrational world. In and around such lucidity, the book is actually quite funny: “Suicide is ugly like KS handbags and doesn’t always walk like a poodle.” As someone used to people wincing at my suicide jokes, Nao’s humor was deeply satisfying. (In our early twenties, my sister and I posed next to a “Your Mother Was Pro-Life” billboard somewhere in North Dakota, or maybe Montana.) Humor provides a powerful antidote to the absurd and ugly. And Kate Spade is just one of many in Nao’s suicide rolodex, alongside Anthony Bourdain and Robin Williams. However ugly, Nao reminds us, suicide is far from abnormal. As much as we’d like to pretend otherwise, it’s common, even banal.

In addition to making an incredibly strong case for expanded applications of death with dignity, Suicide: The Autoimmune Disorder of the Psyche is a survival documentary. Just as clearly as Nao illustrates the problem of suicide, she seems to solve it: “The antidote to suicide is Ali. Someone who cares.” Ali is the friend to whom Nao credits her survival, and the final pages of Nao’s prose weave together scenes of Ali showing up for Nao during extreme distress with discussions of Nao’s impulse to survive on her mother’s behalf: “There has always been this dual, binary conflict in me: my desire to die and my magnetic impulse to continue to exist so that my mother does not suffer from grief.” And yet, like the figures of pi, nothing ever seems quite resolved. She writes, “Years later, at a hospital in Lafayette, where Afib has made life unbearable and unlivable, I find myself wanting to stay alive. Even if that desire appears to be temporary. Or short-lived.”

While reading Suicide, I feel fibers long tense with the righteous anger of abandonment slacken within me. While reading Suicide, I feel something like a connection to my mother’s pain, her agency, her relief. Even if it’s temporary. Even if it’s short-lived.

Adie B. Steckel lives in Portland, Oregon, where they work for an HIV/AIDS & LGTBQ+ health and social services nonprofit and co-edit the small press Fonograf Editions. Other writing can be found online at Annulet: A Journal of Poetics, Dream Pop Press, Harbor Review, Old Pal Magazine, and Tagvverk.

Become a Patron!

This post may contain affiliate links.