Book Review: Dysphoria (Shane Neilson)

Reviewed by Michael Northen

Picture the opening scene of Ridley Scott's film version of Blade Runner and you will have a pretty good idea of the vision of the world that Shane Neilsen sets forth in the title poem of his latest book, Dysphoria. It is a difficult book. The author intends it to be. One almost expects to see a looming subtitle that warns, "Abandon all hope, ye who enter here." Neilson's message does not reach quite that degree of despair. If one line can be plucked out as a sort of guidepost, perhaps it is "In the tire-fire sanctuary of Dysphoria, don't suffer/ acknowledge."

"Dysphoria" constitutes the whole of the first third of the book. According to the blurb on the book's back cover, the poem begins in a solitary room in a psych ward. This precise location is not clear from the first two sections of the poem, but what is clear is that the speaker is receiving injections for some sort of psychological condition, and that from the third section of the poem on readers enter a dysphoric episode that the narrator is experiencing.

Neilson uses a variety of devices to successfully create the sense of Dysphoria – some would say paranoia. The most immediately obvious technique is his use of rhyme. Rhyme is shot throughout the poem, but it rarely end-line. If a rhyming word does occur at the end of the line, then it is mate is half a line away behind it or precedes it by two or three words. This serves to set readers on notice that they are dealing with a mind in which connections are being made but that they are not the neat linear or logical connections that we are taught make up what is considered to be normal. Neilson also throws childlike rhythms and ostinato repetitions into the mix to create a rabbit-hole type of landscape.

In addition to rhyme and rhythm, Neilson uses cultural references to disorient the reader. Percy Sedge, Mad Max, Jim Jones float in and out like a Chagall dream. Figuring out what they are doing or how they function in the poem provides readers with a kind of cyrptograhic puzzle. Some references, like Ahab and Houdini are obvious, others like Rita Charon and Sammy Yatin will send readers to Wikipedia. Neilson delights in cramming other allusions in his lines as in:

And we shall not yield, my fellow
Canadians! We already kneel in beheading videos. Hold me
closer Tiny Dance, to the Pleasure Zone wickedness comes.

As if that were not enough, he creates symbols that only have a particular significance within the dystopian landscape that he creates. Sensor and water tower take on local meanings.

There is a certain sense in which "Dysphoria" is a rant against mainstream medicine, against social policing and against conventional mores in general, but it is also a form of witnessing:

My people are easy to mock and to lobotomize but hard
to fix. No warranties or guarantees for the old and good
body except: beauty is what happens when Murphy's law
applies. Sensor, don't testify. That's what we do.

It is a cautionary tale as well. If we have not quite reached Gattica, we are definitely headed in that direction – particularly in the current political climate. Neilson is Canadian citizen, but what he has to say may be of even greater relevance to Americans.

Part two of Dysphoria bears the title "Medical Inquiries and Observations Upon Diseases of the Mind by Dr Benjamin Rush." Outside of Philadelphia, Benjamin Rush is arguably the least recognized signer of the American Declaration of Independence. Like his fellow signers, Franklin and Jefferson, Rush was a man of many talents. He was a prominent social activist advocating for the abolition of slavery, women's right and providing medical services to the poor. At the same time, he was also a man of his times and advocated practices such as bleeding that often did more harm than good. Neilson takes Rush's paper on the treatment of mental illness and imaginatively rewrites it.

Unlike the initial part of the book, which consisted of one poem, the second is divided into four different sections, each with a number of individual poems. That is not the only difference. It also sheds the frantic narrative voice of the poem (for the most part) and with it moves from only couplets to a variety of poetic forms reflecting the various styles of the material or subjects from which they are drawn. A nice example of this contrast is in the initial poem from the subsection "How to Heal the Sick" titled "Great Care Should Be Taken."

Delusion's a straight
shot to god.
Do not deprive
the mad of it.
What man believes
partly relates to
what he wants
to believe. This
has everything to
do with treatment.
Because delusion is
a line connected
between two dear
points, do not break
the line. Instead,
redraw it by first
marveling at the
line's elegance.

As a reviewer, I will confess that I have not read Rush's book so I am not in a position to know just how many of these phrases are actually drawn from that text and how much is Neilson's re-imagining, but it is fascinating to consider the possibility that an eighteenth century physician was already hinting that difference is an alternative way of seeing or being and not something to be eliminated. Even if Rush feels lines need to be redrawn, he is not trying to eliminate them or dismiss the two points being connected. I'll also add that if Neilson's poems cause readers to seek out copies of Rush's work and become acquainted with how mental illness was conceived of and treated in the eighteenth century, then he has done disability studies a great service. In the process, of course, a reader that motivated is also going to gain a greater appreciation for what Neilson himself has done in creating these poems.

Readers who come from a background in English literature, especially those involved in Mad Studies, will also appreciate the poems drawn from the lives of William Cowper and Christopher Smart, both roughly contemporary with Rush, who lived with mental illness. An entry with the title "Cowper sends Dr Rush an introductory letter outlining the particulars of his case" begins:

I, Cowper, slake thirst with the body
of the lake of fire, to fear one iamb
that becomes a hymn and makes
mystery out of the feeling that washes
my brain

The Romantic fascination of the relationship between creativity and mental illness is one that still persists, but inclusion of these pieces on Cowper and Smart also reminds us (as hinted at in "Great Care Should Be Taken") that this relationship has an even older association with religion.

In any book of poetry the location of the true voice of the author is always problematic even in books of poems strung together in a first person voice. Certainly, the speaker of "Dysphoria" in unreliable in any traditional sense and in the second section of the book, the line between Rush and the author of Dysphoria is unclear (if line is even an applicable metaphor). It is only with the first poem in the third section of the book that we may get insight into Neilson's unvarnished beliefs.

In hooke's eye, pain is an organelle.
Cells die together, as do we.
En masse, the telos is along,


for me, that's never true.
I will die thinking of you. I will die thinking.
Of you, the pain says nothing. You are.
What I say, and sing, for I am in pain,
and have always been: I am alive.

This may not be a particularly original conclusion, but as a means of pushing back, it is at least more than a howl. The book's final section, "Pain on a Scale of One to Ten" is essentially a collection of poems related to the first two sections of the book but that do not fit into their conceptual formats. In fairness, it may also be the space that Neilson has given himself to speak about those things that are personal to him more directly. Several of the poem are for his son and, as the title "The Day My Son Seizure for 27 Minutes, I Wished on a Villainous Star," these are not heart-warming poems. This one in fact is a howl – if an accusatory one. The final poem centers on the death of the poet's mother. Ironically, in a section that that seemed to be more personal, it reverts to the disruptive rhymes of the first section, recalling dysphoria.

The blurb on the back cover of Dysphoria touts that the book "is like nothing you've read before." Notwithstanding the obligatory hyperbole, there is truth to the claim that it is an unusual book of poetry. What makes it atypical is not that a writer can be both a poet and physician – W. C. Williams established that – but that he is a physician who is using poetry to take the medical establishment to task. Disabilities scholars should not get overly excited about this, however, because it's appeal to Mad Studies, notwithstanding, it is a highly idiosyncratic work, not a call for fraternity. While he may speak of "my people," Neilson's agenda, in the end, is an individualistic one. The most significant line in the final section of the book may be the one that he repeats to his son, "And underneath it all is, "I am alone.'" It may be this very resistance to definition, though, that gives the book's its appeal. Given the combination of the dystopic vision the poet creates in the title poem with his imaginative approach to the work of Benjamin Rush, Dysphoria should have a genuine appeal for readers who want poetry to give them an intellectual workout and push them to explore sources beyond the words contained in the book.

Title: Dysphoria
Author: Shane Neilson
Publisher: The Porcupine's Quill
Publication Date: 2017


Michael Northen is the editor of Wordgathering and an editor with Jennifer Bartlett and Sheila Black of the anthology Beauty is a Verb: the New Poetry of Disability. He is also an editor of the recent anthology of disabiity short fiction, The Right Way to Be Crippled and Naked (Cinco Puntos Press).