Radical Tenderness and Illness as Resistance in Amy Berkowitz’s Tender Points

Tender Points by Amy Berkowitz (Nightboat Books, 2019). 144 pages. $16.95.

CW: Child abuse and SA

“I believe that unless we treat each other with tenderness and care now the revolution won’t come. Tenderness isn’t always soft, it isn’t always kind or non-violent—sometimes it’s a person screaming at someone else because it’s the only way they can be heard—but tenderness can make things clear.”

In choosing Francesca Lisette’s words above to introduce her genre-defying book-length lyric essay, Tender Points, Amy Berkowitz frames the work of radical tenderness that her writing both exists within and seeks to further cultivate. A tenderness that “isn’t always kind” but that “can make things clear” is the thread connecting the poetic fragments that make up the essay, a dual exploration of childhood sexual assault at the hands of a doctor and its complex aftereffects manifesting in fibromyalgia.

In a recent interview on the Marxist Poetry Podcast with poet Kim Sousa, Sousa says that she believes that “as poets, we are always reaching for tenderness.” Her saying this made me pause to think on what we mean when we as poets do this reaching: I believe that Berkowitz’s writing offers an excellent ideal of this specific tenderness, or as Lisette defines it, “screaming at someone else because it’s the only way they can be heard.” It is that fierce articulation we reach for as poets. Tender Points, in its individual parts and as a whole, executes this radical yearning, radical in that it asks us to change the way we think about and care for illness (and each other) in a capitalist society; or, more importantly, the ways in which we do neither.

Berkowitz grapples with what it means to exist with chronic illness in the United States when recounting how “I’m having a hard time finding a job because I just moved to the city and because my disability substantially narrows my options. Avoid repetitive motions. That’s kind of the definition of a job, repetitive motions.” If we live in a society where we define a human’s value by their ability to produce or, as contemporary American culture has redefined it, to “hustle,” then what becomes of those who cannot (re)produce the processes and products of capitalism? What happens when the means of being “productive” is in itself a barrier? As readers, we face these questions throughout the essay, and Berkowitz provides no easy answers while also showcasing the glaring inequities in access to resources under such a limiting system.

Elsewhere in this segment, we see money substituted for authentic tenderness. Of her then-boyfriend, Berkowitz writes, “He makes me omelets with expensive ingredients and buys me a record player for my birthday. This, I think, is care.” Note the repetition of “expensive” and “buys” under the category of products for purchase; even the “making” of the omelet itself, is an act of production, thinly veiled as an act of care. Note the hesitation, and/or the hope, in the interrupting “I think.” Under capitalism, care becomes what you can buy.

Berkowitz refutes this, showing that beneath the veneer of what can be bought is not compassion, but a pick-yourself-up-by-your-bootstraps ethos, littered by meaningless mantras that emphasize individual agency and independence. In response to the unemployment Berkowitz faces as a result of her disability, her boyfriend says, “Well, don’t wallow in it. That’s not going to help. Just pick yourself up and get back out there.” If you are someone with chronic illness, such phrases are painfully familiar. They are, as Berkowitz notes, “the words of a little league coach but I am not a little league team. I am a grown person with a disability.” And yet there is this constant infantilizing of disabled people by an abled-obsessed and able-centered society, as if we the ill are simply not doing enough to get over it. It is the myth at the heart of any capitalist society: that we earn our successes and that we earn our failures, too.

Here, also, Berkowitz exposes the limitation of simile: the boyfriend’s bed, first warmly described as a “Reese’s Peanut Butter Cup” (the brand name a direct nod to product as value), reverts to its actual state following this disillusionment: “his bed doesn’t look like a giant piece of chocolate anymore. It looks like a bed.” The simile becomes undone as the illusory connection between what seems like “care” and what is capitalism breaks.

Elsewhere, Berkowitz takes aim at metaphor, to substitute an ideal for a reality, even as the whole of the essay walks the line between poetry and prose. This is particularly apt given its intent to navigate an illness that defies genre itself. Fibromyalgia, as Berkowitz describes, is diagnosed via assessing pain felt in at least 11 out of 18 designated tender points in the body. The slipperiness of language in defining fibromyalgia shrouds the illness in mystery and thus, renders it further invisible. In particular, the fuzzy language, or “this cuddly vernacular,” surrounding fibromyalgia threatens to replace its ugly reality with a sugar-coated substitute: “An episode of extreme pain or fatigue is called a ‘flare-up.’ The cognition deficits experienced by some patients are called ‘fibro fog.’ Why this insistent cute-ing of illness?” In response to this seductively comforting and thus covertly insidious use of language, Berkowitz takes pride in “talk[ing] about my pain in plain language. I use similes when I find them effective—“I feel like I’ve been hit by a truck,’ etc. But mostly I just say how I feel: ‘I slept really badly last night and now my whole body hurts.’”

The straightforwardness of Berkowitz’s writing, with its suspicion of metaphor and defiant “telling, not showing,” calls to mind the work of contemporary poets Wendy Trevino and Joseph Rathgeber, whose work on and off the page focus on anticapitalism. And in fact, Berkowitz notes the German activist group, the Socialist Patients’ Collective, that “recognized capitalism as the root of all illness. To be sick, then, was a political act: a passive resistance against capitalism. The group’s slogan: ‘Turn illness into a weapon.’” Tender Points reveals in exacting language how capitalism so often weaponizes its systems of false scarcity against the ill, in the form of pay-to-play healthcare and employment benefits primarily structured for the healthy. Existing as someone with chronic illness can itself be an act of resistance against the state.

As Berkowitz shows us throughout the essay, easy metaphors—overly simplistic substitutions in place of hard reality—are dangerous in their invalidation of the lived experiences of those with invisible illness. Capitalism demands an illness that can be seen, pain that readily adapts itself to our expectations of what it looks like. Berkowitz cites David B. Morris’s in The Culture of Pain to reflect on how this invisibility played out for her in the workplace: “Female pain is regularly disregarded, discounted, and dismissed, largely because it does not always conform to the clear organic model of appendicitis or a broken arm.” In contrast to her coworker with a broken ankle who “was wearing a boot,” Berkowitz received skepticism and silence regarding her illness, and such pervasive attitudes have tangible consequences: she applied for short-term disability, and her claim was rejected twice. Capitalism demands we show and not tell; this is a fundamental problem for a disease whose entire diagnostic depends on a patient telling the doctor their experiences of pain. Berkowitz depicts how such a callous system places the burden of proof on the ill: if they cannot perform their illness as anticipated, they are not believed.

When illness is commodity and healthcare is a business, disease without the possibility of a cure and with hard-to-define diagnoses become problems because they provide no ready-made and purchasable solutions. This is troubling to a system that sees individuals primarily as consumers. In Berkowitz’s words, for the chronically ill, “Chronic pain is always on a side slash main note.” The nature of suffering from such illnesses is that it exists beyond any possible commodification of it. Despite contemporary American culture’s obsession with recovery narratives, the chronically ill keep on living without any meritocratic (à la “don’t wallow”) recovery in sight.

In the final segment of the book, Berkowitz reveals this resistance as a sick body under a system that refuses to see her pain despite existing inseparably from it. It is a beautiful final segment, in which she carefully uses epistrophe and no metaphors: “My body is riding BART and it’s in pain. My body is politely saying no and it’s in pain. My body is reading a book and it’s in pain. My body is writing this and it’s in pain. My body is walking to meet you and it’s in pain.” The epistrophe “in pain” replicates the ongoing nature of pain that is chronic. It does not, like the Sex and the City episode Berkowitz references earlier in the essay, arrive as a readily solved plot device and go away by the next episode. This pain lingers as “a side slash main note.”

Here, as throughout the entire essay, Berkowitz meets the reader as she is, without substituting in the metaphorized ideal contemporary American society so often asks of the chronically ill. She is in pain and writing still. The act of telling her story in this way becomes its own powerful act of resisting commodification. She resists the use of her illness’s invisibility to deny its existence in portraying her narrative as is, with all the pain of it and none of the trite inspiration porn. And in so doing, her writing is more than an exceptional example of compelling craft: it is an act of radical tenderness as she walks to meet the reader in her pain. She writes in her afterword that “some people have told me that Tender Points helped them feel less alone. I very much hope it can continue to do that.” As a reader, I can say it has done that for me, making me feel seen as few books ever have.

My first encounter with the book happened during the year I was struggling to come to terms with my own chronic depression. I was in my mid-twenties and by then, depression had robbed me of years of writing and reading as I once did; survival was so much of my focus. At City Lights bookstore in San Francisco, I climbed the stairs to their poetry room, hoping that simply surrounding myself with poetry books would remind me of what I had once felt. Then, the vibrant purple of Berkowitz’s book caught my eye.

I sat down right there and began to read it nearly halfway through only to buy it and then finish the rest as quickly as I could. Now, returning to Tender Points roughly three years later, I found myself devouring the book just as eagerly, the pages flipping almost without notice as my eyes lapped up the text. What Berkowitz’s writing provides sufferers of chronic illness is different from so much of the literature out there directed at us. And there are many narratives by sufferers of chronic illness that simply rehash what is expected of them: a gritty love story where the beloved is recovery, where the writer shares how far they have come, how different they are now from the sick self, how recovered, leaving behind so many for whom recovery is not in sight nor a goal that can be achieved. What Berkowitz offers us in Tender Points instead is a radical tenderness: to be seen as we are, without the need of fixing, with full acknowledgment of the awfulness of it. Within this understanding, Tender Points leaves the reader with a sense of hope that feels neither contrived nor small.

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