In 1995 Sarah Manguso was diagnosed with the rare autoimmune disease known as Chronic Idiopathic Demyelinating Polyradiculoneuropathy, which poisons the blood. For the online edition of our Aliens issue, she explores the notion of the outsider through the prism of this illness.


When I was twenty-one I became a citizen of the hospital. I arrived at the border and was examined and let in. Since then I have visited many times. My passport never seems to expire.

After the border crossing I am brought to my lodgings and put into bed and left alone while my itinerary is planned by strangers. Others creep in at night and stab at the crook of my arm. They try to distract me from the blood by announcing how hot it is or how much oxygen it contains.

The charts and logs seem to fascinate my unannounced guests, who pop in and out all the time. They scold me if I fail to finish the contents of my supper tray.

Pink-clad figures appear and beg to be allowed to fetch water or a magazine. They stand at the foot of the bed, wet-eyed, waiting for me to speak. Others, dressed in white, are just the opposite, lecturing without interruption and glancing at me only to confirm that I am listening.

A bag of fluid hangs above my head like a ripe fruit on a metal tree. After some hours the empty skin is harvested and another bag is hung.

Each time I cross the border I note the signs that time has passed. On one visit I find my doors have rudely been marked Fall Risk. On another I am given the infusions gradually instead of all at once. The accommodations are somewhat dirty or very clean. The plastic drapes are blue or green or yellow. The pills come in many sizes and colors. The largest are sent back and mixed into the food.

A man pushes a broom over the floor every day or two, but he expects no gratuity.

Sometimes I can hear the other visitors yelling and crying and vomiting. I don’t want to meet those miserables!

Occasionally an alarm sounds.

After some days or weeks I am told my visit is over and that I am no longer welcome. I am given a letter and told to expect a bill by post. I am pushed through the halls and through the outer gate by someone who bids me good-bye from behind my chair.

My home country expels me from time to time, always against my wishes and with little warning. Whether I live in Iowa or New York or Massachusetts or California, the hospital gate is always just a short drive away.

Though the others greet me warmly on my return visits, I can tell they aren’t glad to see me.


Image by Andy Maguire

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