There are twenty-five words typed on the card on the wall, five rows of five, all nouns: “Ball,” “Tree,” “Dog,” etc. I read the words out loud one by one, first unaccompanied, then along with a metronome at 80 beats per minute, then again at 100. I read the first and the last word of each line at 80, then the second and the second-to-last. Now I hold an identical card and read all twenty-five words, alternating between the card in my hand and the card on the wall. At 80. At 100. I read the first word of each line on the card in my hand and the last on the card on the wall. At 100. Again, backward. I read the words on the card on the wall along with the metronome standing on a mat that throws my feet off balance. Now I focus my vision on the word in the center of the card on the wall: “Dog.” I shake my head back and forth along with the metronome, at 80 beats per minute. Dog. Dog. Dog. The tempo increases to 100 again. The word comes in and out of focus. Dog. Dog. Dog. Thirty seconds. Finally, I stop. I sit down and close my eyes.
The purpose of vestibular therapy is to induce symptoms of dizziness so that the brain becomes accustomed to accommodating them until they subside or are no longer noticeable. It’s a kind of physical therapy designed to train and improve the functioning of the vestibular system —the inner ear—which determines a body’s balance and stable position in space. Dysfunction of the vestibular system can result in a range of complications, from vertigo to ataxia to double vision. I’m currently receiving treatment for convergence insufficiency, a slight misalignment or tendency to turn outward of one eye (my left), and Persistent Postural Perceptual Dizziness, a chronic “non-spinning” dizziness that causes disorientation and foggy thinking without necessarily impeding physical balance. My symptoms are constant, but interfere mostly with visual processing—usually when I’m reading, particularly on a screen, or when I’m in a busy public place.
Eliciting these diagnoses turned out to be far from easy. That surprised me, but not anyone I know who deals with doctors on a regular basis. No one has offered a definitive opinion about the cause of the symptoms, but more than one doctor has suggested that my mostly asymptomatic Delta-era Covid case left me with lingering inflammation in various parts of my body, which I may have exacerbated by freely indulging various habits I now recognize as inflammatory, like eating a high-carb diet, drinking coffee regularly and alcohol “socially,” and a couple of others I’ll elide here as “etc.” Apparently inflammation, like everything else, is a spectrum, always occurring to some degree, at lower levels in those who can tolerate austere wellness regimens like ketogenic diets and high-intensity interval training and far higher levels in those bedridden by chronic autoimmune diseases. I’ve since ceased all of my various inflammatory habits, which I’m told amounts to a lifestyle change, because a spectrum must also describe a lifestyle.
I often use the term “long Covid” to explain the above to friends I haven’t seen in a while, or to acquaintances who rarely encounter a person who doesn’t drink. The doctors I see rarely use this term. In America, doctors treat individuals, not crises of public health, which means patients must seek care as individuals rather than collectively, as members of a population. In any case, right now I’m in treatment not for long Covid but for a specific set of symptoms local to my vestibular system. The measures I’m taking to reduce rheumatic inflammation are mostly based on non-specific recommendations from doctors with unrelated specialties and anecdotal reports from people trying to recover from long Covid at home using various alternative remedies, from multivitamins to infrared light therapy.
After several months with these symptoms, I put on hold all of the various writing projects I had started or assured editors I would start when I still felt well. Keeping my gaze steady while scanning a page of text was hard enough that reading was no longer something I could do without depleting a significant amount of energy, which made maintaining a practice as a literary critic close to impossible, especially when my day job already required reading and writing on a computer screen. I was just becoming accustomed enough to the symptoms to be able to manage them when my neurologist finally referred me to a vestibular therapist. The next day, I received a publicity email from New Directions about a forthcoming translation of Mild Vertigo, a cult novel by the Japanese writer Mieko Kanai, about “the dizzying reality of being unable to locate oneself in the endless stream of minutiae that forms a lonely life.”
Mild Vertigo follows Natsumi, a middle-class housewife in turn-of-the-millennium Tokyo, in looping, third-person, pages-long sentences that would be hard to easily digest even without a reading impairment. Natsumi has two young sons and a husband with a blithe and acerbic manner, the three of whom come and go like background noise as Natsumi observes a low-key but hardly effortless existence, visiting with her next-door neighbor, meeting her old girlfriends for dinner, and attempting to flirt with a younger man. The content of the novel is mostly made up of the details that populate a relatively comfortable urban life: laundry, newspapers, domesticated animals, money, food. Narratively stagnant by design, the text generates urgency and momentum by recreating the experience, recognizable to most people, of constant motion and total immersion in information communicated by an overabundance of visual signifiers. The only recurring narrative development that gives the novel its structure is the bouts of dizziness that strike Natsumi at moments of psychic significance.
The nature of Natsumi’s dizziness is never made quite clear; the words Kanai uses to refer to Natsumi’s symptoms continually change, and their connotations are different every time. The word “vertigo” only appears twice in the text of the novel: once in an essay Natsumi reads about a book of photographs of crowds by the Japanese artist Kineo Kuwabara, and once at the end of the last chapter, when, while on the train, Natsumi visualizes the aisles at her grocery store from memory. In several other instances, Natsumi begins to feel “dizzy,” or describes this feeling herself: when she is in the bathtub imagining an affair between her husband and another woman (“she felt her head growing hazy, despite lying down she began to feel quite dizzy, and it was hard to say whether it was her whole body or just her field of vision”), when she explains the feeling of déja vu to her friend Setchan (“when you become an adult, especially a housewife, you have this feeling of déja vu that leaves you nauseous and dizzy”), and while she is watching the tap water stream out of the faucet into her kitchen sink. The tap water—more mundane domestic infrastructure—is especially activating for Natsumi, inducing dizziness twice: the first time it leaves her in “a kind of trance,” and later, watching it flow, she becomes dizzy and her head begins to “spin.”
From what my doctors have told me, the extent to which dizziness is a physical rather than a mental phenomenon seems to be somewhat nebulous. While balance depends on physical factors like binocular alignment and levels of fluid in the aural canals, the sensations associated with dizziness depend largely on one’s perception of one’s position, or how the brain interprets what the inner ear determines. The inner ear calculates where you are and whether you’re moving, but the brain decides where it thinks you are and whether it thinks you’re moving, and they don’t always agree. In the novel, this distance between position and sensation expands to philosophical proportions. When Natsumi tells Setchan that déja vu “leaves you nauseous and dizzy,” she is really talking about dislocation—in this case in time, which is essentially an existential confusion. Similarly, when she drifts into a reverie in the bathtub and imagines that her husband is having an affair, working herself up until she begins to worry that his lover would judge her for not washing his underwear properly, she is thinking herself into a reverie that metaphysically transports her. In contemporary lingo, this kind of anxious dissociating into fantasy is appropriately known as “spiraling.”
A “trance” (a word that shares a root with “transport”) is its own kind of dislocation, or removal: a retreat from the here and now of one’s immediate external world into a dimension of pure presence. When Natsumi sees the water falling from the faucet, she finds herself “simply staring at it, as if she were being drawn into its motion . . . incapable of turning off the tap.” She asks her husband if he ever finds that in the middle of doing something he starts to “zone out.” The water at first hypnotizes Natsumi, and then makes her dizzy; her fixation on its movement can initiate either harmony or tension. Dizziness takes on a possible spiritual dimension. “There was nothing remarkable about it whatsoever, it was an utterly ordinary thing,” Natsumi muses when she sees the tap water, “and yet for some unknown reason she kept staring at it.” The constant motion of the restless mind and body can cause considerable distress, but maybe it can also, occasionally, open one to transcendence.
Public spaces pose more difficulty in this regard. On busy streets, crowds of moving bodies are not easy to navigate, even for people with all of their faculties intact. In Kuwabara’s photographs, according to the author of the essay Natsumi reads, “all the adults, children, and women who here appear detached from the narratives of their own private lives and histories . . . this all leaves the viewer with a sensation similar to a kind of vertigo.” Vertigo: the word is introduced when what the viewer sees is so complex that it becomes too much to interpret at once. There is too much activity, which is physically confusing, and there are also too many other conscious individuals, which is existentially confusing as well. The sensing body and the feeling temperament are both overloaded. Natsumi’s life in a densely populated and economically deregulated metropolis is one dominated by these physical and existential multiplicities.
Which brings us to the supermarket. In the supermarket of the pop-postmodern novel and poppier retro-pomo movie White Noise, “Everything is concealed in symbolism, hidden by veils of mystery and layers of cultural material.” In the drugstores and shopping centers of Jean Baudrillard’s The Consumer Society, “this metonymic, repetitive discourse of consumable matter, of the commodity, becomes once again, through a great collective metaphor––by virtue of its very excess––the image of the gift.” The supermarket is such a locus of Natsumi’s life that more than once in the novel she lists in her head the exact same series of products displayed there for sale (“. . . raw squid, lightly salted cod, Alaska pollock, fresh salmon fillets, rose fish fillets, sardines, horse mackerel, small horse mackerel for deep frying, smelt for deep frying, scallops for cooking with, steamed scallops, and scabbard fish fillets . . .”), until more than three pages have accumulated. The entirety of the supermarket is imprinted on her memory. She need only close her eyes, and she is there. Why, exactly, does this routine mental exercise make her physically sick?
At home, I write the word “dog” on an envelope in pen and stand it up on top of my bookcase. I set the metronome to 90 beats per minute and shake my head back and forth. Dog. Dog. Dog. I’m reminded of a joke my father used to tell me, a joke I later discovered he lifted from Infinite Jest: What is a dyslexic agnostic insomniac? Someone who stays up all night wondering if there is a dog. I hold my hands out in front of me, raise my two index fingers, set the metronome to 90 again, and look back and forth from the left hand to the right, twenty times. I complete five sets of twenty, then do the same with one finger raised above my head and one held down several feet below it. Eventually I move on to reading numbers on a line spanning from one to twenty, starting at one, jumping to twenty, to two, to nineteen, and so on, first with only my left eye, then with only my right. Then I jump between two lines, from one to one, two to two, et cetera.
The French opthalmologist Emile Javal introduced the term saccade, from the French for “jerk,” as the clinical term for quick movements of the eyes from one focal point to another. Javal took notice of saccadic movement while observing patients’ eyes as they read lines of text. His most famous paper concerns the physiology of reading, which he considers the most fatiguing activity that the eyes perform on a regular basis, and a possible cause of myopia. Reading probably requires the most systematic and repetitive saccadic movements, but the eyes are always jumping from point to point at instantaneous speeds. When we walk down a busy street, we take notice of every passing pedestrian, every street sign or traffic light, every approaching car. When we shop for groceries at the supermarket, we scan up and down every aisle for the right item, the right brand, the right price, dozens of times before we’re ready to check out, usually dodging however many other scanning shoppers as we go. DeLillo plays as a joke that full professors at the college in White Noise “read nothing but cereal boxes,” but stand in the middle of an aisle fully stocked with them and these boxes, with their dozens of brand names, each with its own extended universe of marketing copy and history of federal regulation and review, undeniably constitute a corpus. I’ve had an equally hard time shopping recently at supermarkets and at bookstores.
To accommodate the continuous flow of information our eyes transmit as they dart from one point to another, we develop cognitive models that codify and anticipate familiar visual arrangements. Words and phrases become recognizable by their shapes so that we don’t have to verify their spelling and syntax. (The phrase “Paris in the the Spring” is often used as a psychological test that demonstrates this phenomenon.) The layout of an environment like a supermarket becomes navigable by instinct. The brain prefers to work smarter, not harder, partly because depending on sensory perception for all awareness and decision-making would require superhuman effort and stamina. The brain is more than capable of prolonged heavy reading, but even if we’re named after one of the protagonists, we’re not supposed to read Ulysses every time we leave the house.
Public spaces are not designed and planned to minimize their impact the systems we use to perceive them. (Baudrillard again: goods sold in stores “are always arranged to mark out directive paths, to orientate the purchasing impulse towards networks of objects in order to captivate that impulse and bring it, in keeping with its own logic, to the highest degree of commitment, to the limits of its economic potential.”) Supermarkets, city streets, and cities themselves are built to support commerce––the highway leads you from big box to big box, the bike lane from Trader Joe’s to Whole Foods, contactless payment in fiat or crypto is accepted just about everywhere, within walking distance of every exception there’s a bank or a bank kiosk or an ATM, and this might seem annoying if you weren’t hungry, but you are always hungry; what participating in that commerce does to people is our problem. Before I started Mild Vertigo, I imagined that Natsumi’s dizziness would feel like too heavy-handed a metaphor for me, that her experience wouldn’t ring true, but I can relate to her triggers and how they act on her. Not everyone responds to these triggers like Natsumi does, but sooner or later we all find ourselves rubbing our eyes on the couch, dizzy and worn out, wondering how we managed to get our shopping done.
For the moment, this frazzled state is more or less my baseline. I can bear all of these sensorially involved situations; I’m just unusually attuned to how much they suck. I’ve reassessed what I expect my daily life to look like in the short term, which hasn’t been so easy. Limiting visual input and its attendant mental fatigue requires a wholesale retraining of what has become a reflex system. I have to resist the urge to scroll endlessly, to play music every time I take a walk or tackle a chore, to watch TV with every meal, end every workday with a drink, read every time I take the subway. Aspirationally, I imagine myself working toward something more than just a year of rest and relaxation: I am, I think, returning to myself. I try to experience extended periods of inactivity and silence. I listen to full albums with my eyes closed. Instead of looking up a name or fact I can’t recall, I wait for it to surface in my memory. That I experience these as feats of endurance says something about the person I am, but illness is a part of a person, something a person’s body does. In a lot of cases, life makes this project impossible. I have to be online for work, I have to file my taxes, I always have to buy more groceries or do my laundry eventually. When it’s attainable, though, this private repose can bring a kind of relief.
In a world in which a person is first and foremost an economic unit, attention, participation, and even reliable self-orientation comes at a cost. The same 20th-century canon that assigned so much semiotic importance to the supermarket also demonstrated that the broader network of markets of which we’re all unwitting agents prescribes our basic values and assumptions. With that whole network now online and in front of every eye wherever it goes, one is rarely if ever fully disconnected from its catechism, whether it comes in the form of a Superbowl ad or a viral tweet. I’ve started to think, or hope, that if vestibular dysfunction means a failure to locate oneself within this edifice, maybe it also means an opportunity to propose new assumptions, new values. Without the motion of so many other bodies jarring me into debilitating tension, eventually I should settle down into stillness. In the meantime, maybe I can conjure an assumption that’s wholly mine, a thought that confirms my being, a motion that harmonizes with my own, and hypnotize myself into presence.
