A Handbook for Helping the Dying: The Gifts of the Body, by Rebecca Brown

The Gifts of the Body is labeled a novel, but it functions as a series of interlocked short stories about a home care worker treating patients dying of AIDS. Published in 1994, it recalls a time when an AIDS diagnosis was a death sentence. Its author, Rebecca Brown, worked as a home care worker, which allows her to bring a depth of truth from experience.

Given Brown’s proximity to the subject matter, I was suprised that the opening stories feel oddly impersonal. There’s a distance that makes it difficult to engage with what’s happening on the page. The unnamed home care worker we follow has no internal life that we can tap into, and even the patients seem to be kept at a remove so although we witness their pain and grief as they prepare to die, we don’t get to know them all that well.

As the stories progress, it turns out that this was a deliberate choice by Brown–and a rather genius one. As a home care worker dealing with several AIDS patients at a time, with many more in the past and in the future, this remove is a defense mechanism for survival. Getting close to a patient means it will be more painful when they inevitably go. Of course, it’s difficult to keep emotional walls up, so as the stories progress we learn more about our home care worker, some of the patients from earlier stories return, and everything becomes truly devastating–all the more so because we understand that the loss of this protective remove is causing harm to the home care worker, who begins to experience crippling burnout and depression.

The home care worker is not presented as a saint. She is a flawed human being who just happens to know how to care for the dying thanks to an unfortunate wealth of experience. The patients are mostly unknowable, but Brown makes it clear that this is because the illness has altered them so completely from the people they used to be–another of the many tragedies captured in this slight but devastating volume.

Another thing Brown does that I deeply appreciate is that she resists the all-too-common urge to portray AIDS as something that only impacts gay men. There is also a grandmother in her care and a mother preparing for her own uncertain future. How each patient came to be infected is treated as unimportant compared to the humanity and compassion they deserve, and for this, I will always be grateful to Rebecca Brown.

There have been many advances in HIV/AIDS since this book was published in 1994. Diagnosis is no longer a death sentence, but the illness remains heavily ‘othered’ in most media. The stigma that comes with the diagnosis has long outlasted the severity of the disease, which is why works like this one are so important.

I cannot recommend this book enough. It has easily vaulted onto my list of favorite books.

The Gifts of the Body by Rebecca Brown
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