• Interpreter of Maladies: On Virginia Woolf’s Writings About Illness
    and Disability

    Gabrielle Bellot Explores the Complexity of Detailing Sickness in the Age of COVID

    At the start of 1915, as the First World War raged around her, Virginia Woolf proudly declared in a letter to one of her friends that she had nothing to fear from the flu. “[I]nfluenza germs have no power over me,” she wrote to Janet Case, who had recently come down with the flu; if Janet permitted it, Woolf continued, she would be happy to visit her in person. It was a remarkably ill-timed statement, for Woolf would fall sick with influenza repeatedly over the next decade, at times being confined to her bed as long as eight days. Many of the infections also left Woolf in excruciating physical pain, which was only exacerbated by the extreme surgical measures, like tooth extractions, she occasionally took to alleviate the agony. And the discomfort was not temporary; her physician, Dr. Fergusson, worried that the many bouts of influenza—in 1916, 1918, 1919, 1922, 1923, and 1925—had done lasting damage to her nervous system and heart.

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    The latter was of particular relevance to Woolf, as her mother had died of heart failure due to complications from influenza in 1895, when Woolf was thirteen. In the early 1920s, a cardiac specialist went so far as to predict that Woolf would soon also die. “I was probably dying,” Woolf confessed to her sister about the severity of the 1919 infection. That that year’s sickness seemed so dire was unsurprising, given the likelihood that she’d contracted the Spanish Flu, the virus that would create the century’s most devastating pandemic, killing tens of millions across the globe.

    Still, despite her macabre history with influenza, Woolf still managed to scoff at the pandemic in its early days. In a diary entry from 1918, she off-handedly recorded a neighbor’s succumbing to influenza along with the weather, as if both were equally mundane and unimportant: “Rain for the first time for weeks today, & a funeral next door; dead of influenza.” A few months later, she remarked sarcastically, upon noting that her writerly friend Lytton Strachey was avoiding London due to the pandemic, that “we are, by the way, in the midst of a plague unmatched since the Black Death, according to the Times, who seem to tremble lest it settle upon Lord Northcliffe, & thus precipitate us into peace.” The sardonic tone suggests that Woolf initially viewed the pandemic as a bit of an overblown joke, the comparisons to the plague histrionic.

    While ridicule was a common tool of Woolf’s to sneer at things she disliked, she may have had a deeper reason for wanting to deny the lethality of influenza. In part, she likely wanted to avoid the destiny of her mother, whose death had pushed Woolf to the first of the mental breakdowns that would come to constellate her life’s skies. In Woolf’s words, her “infinitely noble” mother was always an “invisible presence” in her life. “[S]he has haunted me,” she said in a 1927 letter.

    If her mother was invisibly with her, so, too, was Death, which she described as a similarly invisible, haunting presence in “The Death of the Moth,” a 1942 essay on mortality, in which Woolf watches a moth slowly expire, its legs flailing as if against an “enemy.” Death is the “enemy” here, “indifferent, impersonal,” a foe unseen who none of us, moths or matriarchs, could hope to win against. If the fatal effects of the First World War were obvious—heaps of the dead, bombed buildings, letters to family members indicating that someone was never returning—the pernicious presence of influenza was quieter, less overt, but no less lethal; it, too, was an unseen adversary, ubiquitous and unassuming all at once.

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    While ridicule was a common tool of Woolf’s to sneer at things she disliked, she may have had a deeper reason for wanting to deny the lethality of influenza.

    Woolf, it turned out, had no shortage of invisible companions—her mother, the virus that kept attacking her body—and both were linked, in turn, to Death. Death was always with her, the indigo-eyed companion by her bedside, and if the thought of it gave her pain when she thought she, too, was not long for the world, it also gave her solace, because it meant her mother, for all of the ways that she was unlike her daughter, was always near.

    As Woolf knew, illness, like trauma, lingers, even after we think we’ve recovered.


    In 1925, Woolf also suffered another nervous breakdown, and it, along with her many experiences of influenza, prompted her to write “On Being Ill” the following year, a startling essay about sickness in literature. The piece becomes memorable from its first sentence, a long, luxuriant meditation that is one of my favorite first sentences in nonfiction. “Considering how common illness is,” Woolf writes,

    how tremendous the spiritual change that it brings, how astonishing, when the lights of health go down, the undiscovered countries that are then disclosed, what wastes and deserts of the soul a slight attack of influenza brings to view, what precipices and lawns sprinkled with bright flowers a little rise of temperature reveals, what ancient and obdurate oaks are uprooted in us by the act of sickness, how we go down into the pit of death and feel the waters of annihilation close above our heads and wake thinking to find ourselves in the presence of the angels and the harpers when we have a tooth out and come to the surface in the dentist’s arm-chair and confuse his “Rinse the mouth—rinse the mouth” with the greeting of the Deity stooping from the floor of Heaven to welcome us—when we think of this, as we are so frequently forced to think of it, it becomes strange indeed that illness has not taken its place with love and battle and jealousy among the prime themes of literature.

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    Here, Woolf achieves two things: she argues that illness has been unfairly dismissed as unworthy of representation in literature, and, before she has even made this argument, she has already proved it by showing the vast range of experiences that illness comprises, the way sickness makes even an otherwise mundane experience seem tinged with Bardic drama, or the rainy-night fire of noir; illness, in other words, contains the grand battles and unmapped tundras and emotions bright-dark as Picasso’s harlequins present in so many books labeled “important,” yet it rarely appears as a main theme.

    Illness, Woolf says, is relegated to brief references rather than deep explorations, if it appears at all. “Those great wars which the body wages with the mind a slave to it,” she writes, “in the solitude of the bedroom against the assault of fever or the oncome of melancholia, are neglected. Nor,” she continues, “is the reason far to seek”: it takes bravery and vulnerability, “the courage of a lion tamer,” to defy social mores and write honestly about one’s illness, and, to Woolf, few writers possessed this courage to offend by putting their struggles on full display.

    Moreover, Woolf noted that English writers seemed disinclined to write about the body at all, as if it were improper, immoral. Woolf sought a literature that allowed us to write candidly about our body’s experiences. And illness, she proposed, had a startling ability to renew our awareness of the worlds inside and outside of us. In “Art as Technique”(1918), the Russian critic Viktor Shklovsky famously defined the literary technique of defamiliarization, which was to make a familiar thing seem new and strange; sickness, for Woolf, was the great defamiliarizer, causing us to see mundane things, like the sky or a flower, with the awe of a first-timer, because in sickness simple things can suddenly seem incredible once more.

    This, in turn, leads us to explore our own selves more deeply, drifting through our Escherian staircases, our orca-dotted seas. In this way, illness becomes a bridge to writing about both ourselves and the world around us more sharply. Illness is itself novelistic, epic, lyric, if we allow ourselves to express its contours.


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    As a child, I caught countless colds and flus, learning to dread the tickle in my throat preceding a sore throat; later, I was in bed with dengue fever for a week I remember as a haze. I developed a mild case of Covid-19 shortly after New York’s shutdown, losing my sense of smell for a few days. What looms largest in me, though, are the memories of anxiety and depression, the memories of a version of me I wish I could exorcise, but cannot, because they are, like my shadow, inextricable.

    As Woolf knew, illness, like trauma, lingers, even after we think we’ve recovered.

    Writing openly about sickness is almost always scary—all the more so if you have anxiety, which can make you feel anxious writing about anxiety. And if you’re a trans woman of color, like me, you begin to fear revealing too much about your struggles with mental illness, in particular, even comparatively light cases like my own, because you know that many people will simply take your revelations as proof that people like you are disturbed dangers to wholesome, “normal” white folks like themselves. It is common, after all, for critics of trans people to deny the reality of our experiences or the urgency of transitions by claiming we are “mentally ill,” suggesting that we are too deluded to understand anything about ourselves.

    To write about your illness—bodily or mental, because each amplifies the other—is to risk having your experience weaponized against you.

    But I do it anyway, because it is more freeing than not.

    I have heard the crackle of anxiety for most of my life, dull, soft, then unexpectedly loud, like the crackle of a drag on a clove cigarette in a pink evening. I have heard its jazzy electricity, a soft discordant constant like the buzz of an old diner’s neon sign but with sudden spikes in volume, sudden whorls and whirls. Most of the time, I can live with it, even forget its noise, but it is always there, a constant undercurrent in the background of the self, threatening to rise like Hokusai’s wave and take me with it,  and every so often it does, reducing me to a crying wreck, to a howl lonely and loathing as the bellows of the sea-beast in Bradbury’s “Fog Horn,” to shame at your weakness, and this is when it becomes so easy to step into the soft grey quicksand of depression, to sink into that emptying space where you stop feeling at all, and begin to want to end it all, because you fear you are worth as little as you feel when the grey has sapped you of your colors. I know it well, know how the grey once made me want to swallow poison, once got me to go to a train station to step in front of a C train to end my life, made me for years casually hear kill yourself while doing dishes or reading.

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    I control it all better now. I rarely sink into depression’s stone pools, and my anxiety is a softer hum. But the fear of them lingers. I still feel nervous sharing that I deal with either, because even if you exist just fine 98 percent of the time, all it takes is that other 2 percent to make someone look at you different, back away with an awkward smile, and begin to treat you like someone they cannot be themselves around anymore, if they want to be around you much at all.

    Have an outburst when life is genuinely stressful, and you are pathologized; cry in front someone because you, too, are haunted by the ghost of your mother, who is still alive but has never loved you the same since you came out as trans, and you fear being pathologized. You become your struggles, become a mind-body problem that cannot be solved.

    I am still learning, like Woolf, how to reveal.


    One of the few books that did center illness, in Woolf’s estimation, was Thomas de Quincey’s famously hallucinatory classic, Confessions of an English Opium-Eater (1821). De Quincey was also aware of how rarely the English, in particular, allowed themselves to talk about illness, and so he prefaced his book with a wry note to readers about the English dismissing narratives about the sick as nothing less than immoral. He begins by apologizing for

    breaking through that delicate and honourable reserve which, for the most part, restrains us from the public exposure of our own errors and infirmities.  Nothing, indeed, is more revolting to English feelings than the spectacle of a human being obtruding on our notice his moral ulcers or scars. . .

    To write about one’s addictions and pains—one’s illness, in another word—was “revolting,” an obtrusive “spectacle”; de Quincey, like Woolf, sought to do away with that puritanical line of thinking. And, as he notes later in the preface, it was also hypocritical, given the large numbers of English people who took opium in secret, but would rail with the Manichaean fury of a preacher against anyone actually writing openly about drug use and addiction.

    De Quincey’s sentences capture some of the surrealism of taking laudanum, and Woolf’s essay, similarly, has a beautiful, deliberate style. “On Being Ill” is a slow burn, its sentences long, languid, and curlicued like dreaming’s rivers, and it is difficult not to feel drawn in by its lushness. Woolf’s essay is not straightforward, and critics of medical literature have taken her to task for this in the few times her essay has received attention, arguing that her points are weakened by the circuitousness of her style.

    Illness is itself novelistic, epic, lyric, if we allow ourselves to express its contours.

    But this criticism misses the larger point. Woolf didn’t want to create a simple, straightforward argument; her essay’s style itself is a part of the argument. It captures, in its richest moments, the feelings we may have when bedridden: the disorientations, the sudden fascinations with mundane things, the rock-peppered streams of consciousness. The essay’s imagery is constantly in flux, as if, in a bit of metatextual genius, to capture the hazy, Heraclitean impressions of being sick itself.

    Rather than create a direct set of points, Woolf reveled in what Keats famously termed negative capability: uncertainty, the in-between spaces that, for some critics of nonfiction, partly define essays as a genre. An essay can be an essay, in the definition of “essay” that means “an attempt”; an essay functions perfectly well as an attempt to get at an idea, rather than needing to have a clear, linear polemical path. Essays can make clear arguments; they’re also quite free to suggest rather than say explicitly, free to wander the wilds.

    Beyond this, Woolf linked style to gender, with different forms of description indicating something about how one sees the world. She defined these categories in characteristic Woolfian fashion in one of her most playful short stories, “The Mark on the Wall,” in which two characters—the narrator implied to be a woman and the other a man—respond to an unidentified mark on the wall quite differently. For the narrator, not knowing what the mark is inspires a series of surreal associations, and she revels in the uncertainty because it is enjoyable to speculate; the man, however, sees the dot and immediately labels it nothing but a snail, bringing the story, and the imaginativeness, to an abrupt end.

    For Woolf, this difference mattered. Blunt, abrupt, direct sentences that declare, with certainty, what something is represented “the masculine point of view,” while longer, more imaginative, uncertainty-privileging sentences were “feminine.” The narrator dislikes the speculation-ending masculine point of view, “which soon, one may hope, will be laughed into the dustbin where the phantoms go.” Style, then, is substance, is spirit, is Weltanschauung. “On Being Ill” privileges this roving style, so that you don’t just say, “I have influenza” and leave it there, but show what it feels like.

    Woolf’s concerns also animated the critic Elizabeth Outka, whose Viral Modernism (2019), a study of the 1918 pandemic in Modernist literature, came out, appositely, just before our own generation’s pandemic. In a moment of macabre insight, Outka notes that “certain types of mass death become less ‘grievable’… than others, with deaths in the pandemic consistently seen as less important or politically useful. The millions of flu deaths,” she continues, “didn’t (and don’t) count as history in the ways the war casualties did.” Outka’s study seeks to answer a curious question: why the pandemic, despite its staggering scope, so rarely seems to appear in Modernist literature of the period. In reality, the pandemic is there, in both passing references and even, arguably, in some of the disorienting, fragmentary stylistic choices of the era, which may reflect the hallucinatory experience of severe influenza. Yet it is all too easy to take a course on Modernism with only a passing nod to the pandemic, if you get that at all, while the First World War, which helped amplify the virus’ spread, will always be discussed.

    This happens even in discussions of Woolf’s other overtures to illness, like her celebrated novel Mrs Dalloway, which mentions influenza but is rarely spoken of as a pandemic novel. Here, too, the war takes critical precedence: critics have overwhelmingly focused on Septimus, the shell-shocked soldier, as the book’s image of trauma, often ignoring that, in Outka’s words, Clarissa is a “pandemic survivor” who deals with “lingering physical and psychological damage” from influenza. (Septimus, however, may also have been lastingly affected by the virus, Outka speculates, given its prevalence amongst soldiers and his delirium-like symptoms.) Clarissa is described early on as having “her heart affected…by influenza,” like Woolf and her mother; her grand joy at going out to get the flowers herself, the desire that starts the novel, suggests that her sickness prevented her from leaving her home before then, a detail darkly reminiscent of the coronavirus pandemic’s psychological effects on the quarantined.

    “On Being Ill” is a slow burn, its sentences long, languid, and curlicued like dreaming’s rivers, and it is difficult not to feel drawn in by its lushness.

    A part of the problem, Outka says darkly, is a tendency to sweep away illness as less noteworthy than, say, a war, and this desire is tied to gendered norms of what is casually considered “important,” whereby war, a stereotypically “masculine” activity, takes precedence over almost all else. While I dislike following norms of gender, it’s difficult not to see these tendencies at play in discussions of Woolf’s era. “When we fail to read for illness in general and the 1918 pandemic in particular,” Outka writes in a memorable passage,

    we reify how military conflict has come to define history, we deemphasize illness and pandemics in ways that hide their threat, and we take part in in long traditions that align illness with seemingly less valiant, more feminine forms of death.

    Thankfully, this is beginning to change, thanks to books whose authors put their struggles with illness front and center, like Sick, Porochista Khakpour revealing memoir of Lyme Disease; The Collected Schizophrenias, Esme Wang’s intense, intimate essays on living with mental illness; My Year of Rest and Relaxation, the by-turns-humorous-and-harrowing novel by Ottessa Moshfegh about intersections between mental illness, privilege, and American society; or Kaveh Akbar’s astonishing poems of addiction, Portrait of the Alcoholic. These books, alongside so many others, place illness of one kind or another at the forefront, allowing readers not just to observe but to feel what it is like to be sick—and there’s something beautiful amidst the poignancy in this vulnerability.

    Yet it is still difficult to be taken seriously once you admit—or confess, as de Quincey did—to having to struggle with something, and it is clear that some of that old desire to simply not have us dirty up a narrative with our illnesses. It’s worse, still, for those of us who are nonwhite and trans in America, when our revelations merely reinforce racist and transphobic stereotypes about our stability, our danger to others, or the very validity of our thoughts.

    We have come far—but we’re far from where we need to be, all the same, when Woolf’s essay still has the power to seem subversive.


    Our pandemic is both similar to and distinct from the one Woolf lived through. The Spanish Flu was horrifically devastating, its death toll amplified significantly by soldiers from the First World War bringing the virus with them as they traveled. The coronavirus is also destructive (though unquestionably less so), but we have better medical tools to deal with it now, and its death toll will almost certainly be lower, though no official toll can grasp how many have truly died, in Woolf’s day or ours, because the reach and ramifications of a pandemic are almost always wider than we can comprehend.

    This pandemic will end—possibly even sooner than we may think—but it will not end all at once. Instead, as in Camus’ The Plague, the effects that this period has had on us will linger, even if we don’t fully realize how deeply we’ve been affected. Although we will be able to return to something like normalcy one day, due to a scientific miracle of speed in vaccine production that we must never take for granted, we won’t return to exactly what we were before; we will have changed, because this pandemic has changed all of us, even those who claim there is no pandemic at all. Some of the changes, to ourselves and societies, may be good, helping to show the work for equal access to healthcare and financial aid that urgently needs to be done.

    Other changes, however, may even seed future pandemics, like the non-immunocompromised people who claim they will never stop wearing a mask or let their kids go anywhere unmasked even after vaccination, a practice that would obviously harm their immune systems in the long run. Egos on social media, stoked already by sanctimonious bragging tweets about, say, how many masks they own, may simply enlarge further as they brag about, say, not taking a coronavirus vaccine, a position that—if the vaccines are shown to work—will amount to anti-intellectualism for “likes” that lengthens the span and death toll of this pandemic, or the next.

    We do not win against viruses; we live with them always at the door of our worlds. If we kick one out into the obsidian of the past, lovely; others will always be there, prolific as the microbes we carry around inside us every day.

    Regardless of all this, whenever the pandemic is over, we must practice a deeper form of self-care—be it through celebration or separation for a little longer—than we’ve ever done before to begin to really heal. As Woolf knew all too well, illness is itself a kind of invisible presence in our lives even when we think we’ve recovered.

    How we speak of pandemics matters, too. Woolf used militaristic imagery in “On Being Ill”; sickness was a grand “war.” This is how so many in power have described our relationship with the coronavirus: a battle to be won. But this is wrong. The coronavirus is simply another entity (almost an organism, though viruses aren’t quite alive) we live in relation to, and that our species has always lived in relation to since we happened to evolve, on our pale blue planetary dot. Viruses do not likewise “see” us as enemies; we are simply means of propagation, the coronavirus no different in this sense from any other. And viruses far outnumber humans—and all other organisms—on Earth.

    But this isn’t cause for alarm; it’s always been this way. We do not win against viruses; we live with them always at the door of our worlds. If we kick one out into the obsidian of the past, lovely; others will always be there, prolific as the microbes we carry around inside us every day. Pandemics will likely never stop occurring—and this is scary, yes, but it doesn’t have to outright petrify us, because this is merely the social contract of life, the natural contract, we sign when we are born. It’s easy to forget how fragile we are, how extraordinary it is that humankind has survived as long as it has. But we have, through plagues and pandemics, and will continue to, somehow, because that’s what we do—and that’s kind of incredible, really.

    When we stop thinking about defeating viruses like enemies, we can better appreciate our tenuous place on this planet and learn to cherish the brief time we have, in sickness and health alike. Woolf understood well the smallness and precariousness of humankind in the grand scheme of things, but she kept going, anyway, so that she could write—the thing she loved—even with the agony of mental and physical illnesses as her backdrop, for as long as she could muster the urge to keep living. As much as we can, we will survive by doing the same, focusing on what and who we love, no matter how near Death, our invisible companion, seems.

    Gabrielle Bellot
    Gabrielle Bellot
    Gabrielle Bellot is a staff writer for Literary Hub. Her work has appeared in The New York Times, The Atlantic, The New York Review of Books, The New Yorker, The Paris Review Daily, The Cut, Tin House, The Guardian, Guernica, The Normal School, The Poetry Foundation, Lambda Literary, and many other places. She is working on her first collection of essays and a novel.

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