The Invisible Kingdom

Meghan O'Rourke narrates her harrowing account of spending years trying to find a diagnosis for her chronic illness. She takes listeners through a multitude of medical appointments, experimental procedures, and tests. The decades-long process sounds exhausting, and O'Rourke makes it clear to listeners that it was. By delivering her own memoir, she captures the emotional pain, the uncertainty of the seeming void of her future, and the joy of finally becoming healthy enough to have children. Reliving all of those moments must have been painful, but hearing those emotions make this experience much more real and effective than it would have been even in the hands of a gifted professional narrator. A.R.F. © AudioFile 2022, Portland, Maine

In her early 20s, Meghan O’Rourke began to experience an array of symptoms—fatigue, joint pain, brain fog, hives, fever, a sensation of electric shocks along her legs and arms—that neither doctors nor bloodwork could connect to a diagnosis. When one doctor suggested that O’Rourke might have an autoimmune disease, a condition in which the immune system begins to turn on the body, O’Rourke recalled her practical Irish aunts who lived with rheumatoid arthritis, Hashimoto’s disease and ulcerative colitis, all autoimmune diseases. As O’Rourke entered her 30s, her symptoms grew worse, despite seeing multiple specialists. She found herself barely able to leave her apartment, let alone have the baby she’d been hoping for. O’Rourke is the author of three collections of poetry and a memoir, The Long Goodbye. In The Invisible Kingdom, she chronicles her long search for healing, layering in extensive reporting on the rise of chronic illness and autoimmune disease and the way our medical system fails to see ailments that aren’t readily diagnosable or easily treated. Likewise, she notes that autoimmune diseases are far more likely to affect women, and women, in turn, are more likely to be told that their symptoms are all in their heads. “Of the nearly one hundred women I interviewed, all of whom were eventually diagnosed with an autoimmune disease or other concrete illness, more than 90 percent had been encouraged to seek treatment for anxiety or depression by doctors who told them nothing physical was wrong with them,” she writes. O’Rourke examines her own experience with a lucid but compassionate lens, and she brings that same mix of analysis and compassion to the book’s reporting. It’s a delicate balancing act to write about a long journey of misery without being tedious or repetitive. She pulls it off by adding lyrical imagery and the words of other writers, such as Alice James and Susan Sontag, to her descriptions of suffering, the peculiar treatments she found herself undergoing, and the effect her quest for healing had on her marriage. And yes, the book reaches a happy, though not uncomplicated, ending. While it’s especially useful for those who have personally encountered chronic illness, The Invisible Kingdom will add to everyone’s understanding of disease and health. Ultimately it offers a fresh image of what good medicine could look like: doctors understanding each patient as a whole person, not just as a collection of parts.