When Maddie and I interviewed John Hunter of Hunter Publishers a month or so back, he brought along a stack of books for us, an expansive gesture that Maddie, better tenacious of her good breeding than I am (sorry, Mum and Dad) took the lead in declining to fully exploit. But neither of us could resist taking one book each from the proffered pile, and there was a dog fight over Sarah Manguso’s The Two Kinds of Decay. I won — spurred by Older Sister Entitlement Syndrome — and Maddie took away the tantalising, not-really-second-place Oink Oink Oink by Eric Yoshiaki Dando.

I’m not usually a scrapper, and I don’t think Maddie is either. But John was describing how he’d discovered Manguso’s writing — she’s a poet and short fiction writer, an Iowa alum — and came to buy the Australian rights to The Two Kinds of Decay, a memoir about her experience with a disease called chronic idiopathic demyelinating polyradiculoneuropathy (CIDP). Both us girls (well, I’m extrapolating from how I felt) were intrigued and touched by the story and its short-sections format, and I got stuck into it pretty much straight away.

Like most human dramas seem to do, Manguso’s sickness crept up on her without any warning. One morning in 1995, when she was washing her face, she couldn’t catch her breath and her hands started tingling. It was a strange affliction that became more severe over the next couple of days, though with the average person’s blithe lack of presentiment for catastrophe, her worry was mostly directed at the collateral effects:

I was concerned I’d caught a strange illness, but I was more concerned that I looked drunk. I was staggering around, even to and from breakfast, and I felt people looking at me and thinking it might be time for an intervention.

Only a day later, she fell down in her university’s courtyard. Her mother took her to the hospital and in twelve hours she was hooked up to a machine and warned that she would be intubated through a hole in her neck if she deteriorated any further.

What followed was four years of medical treatment so intense that ‘intrusive’ doesn’t quite cover it. In CIDP, the immune system secretes antibodies into the blood, and these antibodies destroy the patient’s neurons. To avoid the effects of this self-destructive cycle, Manguso had to undergo apheresis, ‘from the Greek aphairein, to take away’. Her blood was fed into a machine that spun the blood into its separate components, removed the poisoned parts — in Manguso’s case, the plasma — and guided back into the body once mixed with saline and artificial plasma.

The matter-of-fact way in which Manguso describes the effects and the equipment of her illness is simple, though not inhumane or stark. She reports the taste and the cold of the plasma infusions, inescapable because they are inside her; and it’s difficult not to put one’s hand to one’s neck and close the book and be of one’s own body for a moment. Weakness is one of the accompanying detriments of CIDP, with the limbs becoming too impuissant for common tasks. This leads to impossibilities where once there was effortlessness: the section entitled ‘Blood and Shit’ tells of the cheerful nurse who ‘really knew how to wipe an ass’, and Manguso’s gratefulness for the competency with which her favourite staff would accomplish these intimate duties. Less able to be imparted without horror are the tales of professional inadequacy. In ‘The Sikh’:

He tried again and again to jam the tube into my vein. Every now and then he had to stop and apply pressure, as I was bleeding. At one point I thought I felt a jet of blood spurt into my chest cavity, and that’s when I lost my composure.

Months later, after his hair had gone from steel gray to white, my father told me it had looked like a horror movie.

While her writer’s nous enables her to figure her observations as salient themes or lessons, Manguso’s poet sense also conveys understanding in impressionistic flashes. At ‘The End’, she learns to ‘pay attention’; and that ‘to pay attention is to love everything’: a conclusion as comprehensive and inscrutable as monks’ replies to koans.

Not elegiac, but clear and aware, Manguso’s memoir is a bright prism for insight into the matrix of sickness and strength. Written seven years after her recovery, The Two Kinds of Decay uses a structure of fragments to translate life’s linear chaos into something multifaceted and utterly graspable. In a cruel bracket of life where the words ‘prednisone’ and ‘bolus’ and ‘fear’ become daily companions, and doctors and nurses number among the most common cast members, humanity might be a person’s most precious and most tenuous asset. Manguso’s powers of pellucid distillation guarantee the preservation of that humanity in the telling of a story with the power to all but devour it.

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Next on the list for me is certainly some of Manguso’s poetry. Also, she is working on a novel: ‘it’s called The Guardians, and it’s about surveillance and paranoia’.