Shattered, a memoir by novelist, screenwriter and playwright Hanif Kureishi

Hanif Kureishi is a novelist, screenwriter, and playwright. He is the author of nine novels, including The Buddha of Suburbia (winner of the Whitbread Award for Best First Novel), The Black Album, Intimacy, and The Nothing. His screenplay of My Beautiful Laundrette was nominated for an Oscar, and he is the recipient of the PEN Pinter Prize and the Chevalier de l’Ordre des Arts et des Lettres. He was made a Commander of the Order of the British Empire. He lives in London.
Author hoto by Kier Kureishi

In December 2022, novelist, screenwriter (My Beautiful Launderette) and playwright Hanif Kureishi was at his girlfriend Isabella’s apartment in Rome when he had a fall after fainting due to a change in blood pressure. Because of how he landed, he ended up hyperextending his neck resulting in immediate tetraplegia. His memoir Shattered (Ecco, 2025) is his account of the following year he spent in various hospitals and rehabilitation centers as he tried to understand how he would live moving forward, as the accident reshaped his view of himself and his body, especially what that means for him as a writer.

 Throughout the book, Kureishi has the reactions one would expect from a life-changing event such as his. He cycles through Kübler-Ross’s stages of grief, though he never reaches acceptance (he has moments of hope, though), and he spends most of his time in anger and depression. Kureishi shares moments of disbelief—how waking up (when he’s able to get a few hours of sleep) can be the worst moment of the day, when he realizes all over again what has happened to him. It’s like “re-entering a horror movie that I had thought, for a moment, I could turn off.” He sometimes suffers from envy, especially when friends who visit him talk about going on vacation and he recalls what it’s like to travel with such ease.

He doesn’t say much about the care he receives, but that’s mainly because of the boring routines of a long hospital stay. Early in the book, he does provide details, even interjecting humor to his description of receiving an enema, but once he’s established that routine, he shifts his focus away from the medical descriptions. Similarly, given that he moves through five different hospitals/rehabilitation centers, he doesn’t truly get to know the people who care for him. Not only that, he notices the turnover in the staff, which prevents him from knowing them more fully. That’s a frustration for him, as he seeks to build relationships in a place where he’s spending several months of his life.

Empathy plays a part in how he sees his caregivers, as he reflects on all they do for him and how they see their job as a calling, despite the long hours and low pay. The experience is as humbling as it is existentially exasperating: He learns how to ask for help, as he has lost the ability to do anything for himself. Kureishi makes a clear contrast between the hospital in Italy, where he spends the first five months, and the various locations in England, which range from grim to adequate. There’s an implied criticism of the British National Health Service, but he never comes out and skewers it directly. As an American reader, I couldn’t help but wonder how much all of his care would have cost in the U.S. system and how somebody who makes their living as a writer would be able to afford it, even with insurance.

The main strength of Shattered consists of reflections on his identity after the accident. Early on, he writes: “I am a stranger to myself. I don’t know who I am any more. Someone new is emerging.” After ten months, he reflects, “I can feel my identity slipping, as if I am forgetting who I am and becoming someone else, or almost nothing. I never thought my identity would be scrubbed out or superseded by something else.”

Part of that change revolves around the idea of disability. He has gone from being a person who could function in a society built for those who are physically able to move around without assistance to somebody who requires help for every action they want to do. Daily activity becomes heightened for him: For example, Kureishi describes how those helping him eat either give him food too quickly or not quickly enough, a distinction most readers wouldn’t have thought about but one that makes perfect sense once one stops to consider it. For his return home to his house in London, a number of accommodations are needed, including adding a bathroom and bed to the main floor. The most mundane activities must be navigated with care. Kureishi chronicles, for example, the amount of attention he has to pay to the uneven quality of the sidewalks when he and one of his sons go to a pub.

He devotes a small amount of time to thinking about sex, as well as a discussion of psychoanalysis (which he has been in for decades), but not how he and Isabella will continue to have any type of intimacy. Instead, he talks about the sex he had in the past and his lack of interest in it now. He’s frank about it, even making Isabella uncomfortable in relating a story about a supposed orgy he was a part of (the story does not live up to that description), but he doesn’t seem concerned with it moving forward.

A Writer’s Life, Interrupted
Given how much of Kureishi’s life consists of writing, that part of his identity comes in for the most scrutiny. He wonders what life is like as a writer who is unable to pick up a pen and physically write. The only way he was able to compose Shattered, for example, was through dictation and the help of his family. It is telling that Kureishi begins writing this book within a couple of weeks after his accident, as his way of processing the world. In his first entry, dated 6 January 2023, he ends by saying, “I am speaking these words through Isabella, who is slowly typing them into her iPad. I am determined to keep writing, it has never mattered to me more.” One of the reasons his identity as a writer is so important is because it has provided him with an identity of his choosing, unlike the racial identity British society, especially his peers, put upon him when he was younger. After providing a list of words other people called him, he “found [his] own word, [he] stuck to it, and never let it go. It is still [his] word.” Some of the strongest sections of the book, certainly some of the best quotes, come from his thoughts about writing and being a writer.

Occasionally, he forgets the privilege he does still have as a male writer. He tells the story of one of his students who is working on a novel. Before giving a draft to an editor or agent, she asks a sensitivity reader to evaluate it to see if it contains anything that is offensive. Kureishi is appalled by such an idea and spends several pages talking about how writers of the 20th century would not have taken such an approach, that the point of literature is to transgress, especially writers such as Dostoevsky, Sylvia Plath, Jean Rhys, Céline, William Burroughs, Henry Miller, James Baldwin, Franz Kafka, and D.H. Lawrence, all of whom pushed boundaries and forced readers to see a wider world. He fails to notice that most of them are male—Rhys and Plath are the exceptions— and while there have been female writers who were literary disrupters, it has been (and continues to be) much more difficult for them to do so.

 One other aspect of his identity that he explores is the nature of his body. He admits he hasn’t thought about his body much during his life, as he’s not an athlete and hasn’t suffered from any other significant ailments or injuries, but this accident has brought him more in touch with that body, even as it has become more of an object. At times, he talks about parts of his body as if they don’t belong to him, given his lack of control over them, but he’s also fascinated with what his body can and can’t do. His hands are of particular interest, given they are the conduit for his writing. He regularly mentions how he has given up any kind of embarrassment about his body, given how often people undress and wash and handle him, which causes him to see his body as more of an object, but also to appreciate the lack of judgment from those who do such work.

 His list of acknowledgements is longer than for most books, given how many people have taken care of him. He spends some of the time in the book talking about the effects such care has taken on his family. His now-fiancée Isabella (they get engaged during the course of the book) has effectively given up her work as a PR agent for writers and festivals to be there for him, and his three sons work out a rotation of visits to help her. He describes the change that happened:

“Two weeks ago a bomb went off in my life which has also shattered the lives of those around me. My partner, my children, my friends. All my relationships are being renegotiated. It makes everybody a little crazy, it changes everything. There is guilt and rage, and people resent their dependence on one another and the fact they can’t do everything for themselves. My accident was a physical tragedy, but the emotional outcomes for all of us are going to be significant.”

He also talks about the wide variety of friends and even acquaintances who come to see him, with Isabella even joking about how busy his room often is. There are days where several people end up there at the same time, having lengthy intellectual conversations, much like they would have had in the past. On most of those days, he’s suffering too much to truly enjoy them, but it’s clear he noticed them, given that they show up in his account. He realizes that such an accident has taught him who his true friends are, and he reflects on when he might not have been as good of a friend as he should have. Like most of us, he resolves to be different moving forward.

I would be remiss if I neglected to mention the humor he works throughout the book, given the lack of jollity in his situation. He tells the story of a time before his accident when a nurse mistook him for Salman Rushdie—the author of Midnight’s Children and one of Kureishi’s friends—while a nurse was flipping him over, preparing to put a finger in his “backside.” Kureishi jokes that if he had written Midnight’s Children, he would have “gone private,” implying that he would be able to afford private care and wouldn’t be in such a public setting, given the threat on Rushdie’s life. When he relates a story about having a long conversation with a doctor in Italy about raising children, translations of Russian novels, the doctor’s performing surgery on a Mafia don, among other subjects, Kureishi ends by saying, “I have to say that becoming paralyzed is a great way to meet new people.”

The book ends with his going home to a different life, but one where he can still find some joy in the world. His book is not treacly or saccharine, as he doesn’t try to deliver any life lessons he’s learned along the way, nor does he end with any implication that moving forward will be easy. However, he has begun to try to see the small parts of life that will continue to provide happiness. In fact, he reflects on the collaboration of editing this book with his son Carlo and how much he has enjoyed that. Even if he doesn’t pick up a pen again, it’s clear Kureishi will find a way to communicate with the world around him.—Kevin Brown

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Kevin Brown (he/him) teaches high school English in Nashville. He has published three books of poetry: Liturgical Calendar: Poems (Wipf and Stock); A Lexicon of Lost Words (winner of the Violet Reed Haas Prize for Poetry, Snake Nation Press); and Exit Lines (Plain View Press). He also has a memoir, Another Way: Finding Faith, Then Finding It Again, and a book of scholarship, They Love to Tell the Stories: Five Contemporary Novelists Take on the Gospels. Find out more about him and his work on social media sites at @kevinbrownwrites or at http://kevinbrownwrites.weebly.com/.

Our Long Marvelous Dying by Anna DeForest

One moment of Anna DeForest’s Our Long Marvelous Dying, just published by Little, Brown and Company, captures the immense grief at the root of their new novel:

 In the interval between giving a dose of intravenous opioids and seeing the peak effect, I will sometimes pass the time by catching up on the news. There is almost always a disaster imminent…You get used to it…

A sense of resignation and detachment pervades the story told by an unnamed narrator, who works as a palliative-care fellow in New York City after the peak of the early COVID-19 pandemic.  In the first chapters, she recounts aspects of her training as a specialist, who “serves as a sort of illness interpreter, bringing the jargon of clinical medicine into the life and language of the patient who is living the experience.” It’s a specialty also “trained to be comfortable with [prescribing] the stronger stuff: morphine, hydromorphone, fentanyl.” As the fellow learns these skills, an assessment of how her specialty serves the dying patient and her colleagues becomes clear:

The trouble that the other doctors have is not a lack of gentleness. Well, not only that. More often what they cannot do is tell the truth. They pack death up in so much misdirection, talk about the success or failure rate of this or that procedure or treatment, when the truth is the patient will be dead soon no matter what we come up with to do in the interim. That’s the part they need a specialist to say.

 We also get glimpses of the narrator’s personal life: her relationship with her husband Eli, the dark ground-floor apartment they rent, the chess games she plays with her young niece Sarah, who her brother has left with them. We learn about the death of her father. Throughout the novel, the narrator seeks ways to withstand suffering—the global and local, present and past—in her daily existence.

Anna DeForest (they/their) is the author of the novels A History of Present Illness and Our Long Marvelous Dying, and a palliative care physician in New York City.

Photo by Stephen Douglas

Our Long Marvelous Dying is DeForest’s second novel and in some ways narratively follows A History of Present Illness, published in 2022, which challenged the lore of medical education through the story of a student managing her own personal trauma and the wider trauma of American healthcare. Reviews of DeForest’s first novel linked the writer, who works as a palliative care physician at Memorial Sloan Kettering Cancer Center in New York City, to the narrator—and the same might apply to Our Long Marvelous Dying, as many moments seem pulled from the firsthand experience of a physician versed in hospice and palliative care.

In many of the novel’s settings, bereavement surrounds the narrator and often consumes her. But the grief that grounds the story and proves most unsettling for the narrator stems from the death of her absent and unkind father. DeForest structures the story to reflect the narrator’s apprehension towards him. We see him in pieces between scenes in the hospital, and can’t put him together as a whole until the very end. In managing the arrangements for his death, the narrator takes us through their fraught relationship. His favorite story to tell her romantic partners when meeting them for the first time is how whenever she cried as an infant, he said “I never liked you from the beginning.” But the cruelty of his abandonment is in its persistence—he is a “latent monster,” a “ghost” from whom she never stops craving acknowledgement.

Beyond her family, the narrator guides us through additional layers of grief in a way that we never stay long enough in one place to take up the devastation. The world offers constant tragedy—floods, destruction of coral reefs, extinction of thousands of species. And every day the COVID-19 pandemic rages. The reader hears about the refrigerated trucks lining New York City blocks, but what the reader sees in specific detail are the causalities for healthcare workers: their loneliness and coping mechanisms of alcohol use, disordered eating and SSRIs for suicidal ideation. During rounds, for example, an attending physician recounts the peak of the pandemic and says absently, “I am on an SSRI.” Meanwhile, the narrator notices the spring air coming through the window in his office that has “no bars, no screen. Fourteen floors up, with a view of the Empire State Building.” There is an omnipresent threat of self-harm, if not from one tragedy, then from the weight of so many others. 

But Our Long Marvelous Dying is not a trauma dump. It confronts the obvious truths we train ourselves to overlook: the truth of death in a hospital, the truth of our own progression to death. It forces the question of “what is the purpose of living?” and does not give a satisfying answer. In this way, the novel’s title does not allude to the hidden deaths in the hospice wings, it alludes to us. Without despair, the narrator states “that all of us will die…that all of us are dead already.” The narrator acts as a palliative-care physician for us all, interpreting the jargon and euphemisms that drown the simple truth of daily tragedy.  The sugar coating has dissolved, and she wants to communicate that “no one is coming to comfort you” and “nothing will help.”

 One of the most provocative aspects of DeForest’s work is their ability to situate the reader in the day-to-day clinical world. The narrator normalizes death, dying and the grim collapse of human bodies that happens, not because of dispassion, but because of routine. While contributing to the book’s undercurrent of grief, the hospice unit provides meaning on a quotidian basis. On a phone call, in response to a mother’s dismay that her daughter may die before they arrive, the narrator reflects: “of course she can and does die alone.” In another situation, she reflects that an aging actress “dies the same as anyone.” These are tragedies that are contained, expected and managed. 

Despite submission to muted sorrow, the narrator still attempts to manage her trauma. The palliative-care fellowship itself, in the view of its program director, draws those with personal layers of grief in addition to their professional interest. For the narrator, her work keeps the despair at bay and allows her to reflect on the minutiae of existence—for example, describing her underground commute as “the long stretch of track between where I live and everything that matters.” In revolving her life around the care of others, she does not have to generate her own will to continue living.

She also tries to endure by tempering her connections, especially to her husband Eli, a “well-adjusted” and handsome chaplain with a network of friends who adore him. The constant in their marriage is the restrained threat of its end, from “red flags” or laments that “it isn’t working.” This sense of detachment also manifests with her niece Sarah, who she describes as her “temporary daughter” while Sarah’s father is unable to care for her due to his substance use. We learn that an intergenerational dearth of attention and love has conditioned the narrator to the security of pain rather than love; the cycle of abuse contributes to her decision not to have children. The place where she seeks connection is a monastery out of the city, where she arrives and departs anonymous to her peers.  

While there is no neat resolution, the protagonist steadily approaches the grief that eludes her—the death of her father. We see this through the lengthening of the scenes themselves. Initially, we learn about her father in brief moments between scenes of her palliative-care fellowship; by the end, we are allowed to linger as she sorts through his belongings. For a person who asks uncomfortable questions (Are you happy?) and speaks revolutionary words in a hospital (death and dying), the narrator takes her time to confront his death. She asks a rabbi at the hospital what to do after death about the bad acts her father committed in his life. Just as she can cut through medical euphemisms and jargon, he cuts through her question: “The weight you feel, he says, is not a need to forgive anyone. Just call it grief. Call it trauma.”

In Our Long Marvelous Dying, DeForest challenges our discomfort with death and instead leads with loss and our search for meaning within it.—Margo Peyton

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Margo A. Peyton is a resident physician in neurology at Massachusetts General Hospital and Brigham and Women's Hospital. Prior to medical school at Johns Hopkins, she worked in film and television story development for DreamWorks Animation. Her essays and book reviews have appeared in The New England Journal of Medicine, JAMA and the Boston Society of Neurology, Neurosurgery, and Psychiatry.

Aging as a Spiritual Practice – A Contemplative Guide to Growing Older and Wiser By Lewis Richmond

Western society does everything possible to convince us we can live forever. But death is inevitable. We all age and die. No one is exempt. How can we approach this stage of our lives with acceptance, wisdom, appreciation, and even joy? As a physician, I was not afraid of dying, but as I aged, I was unprepared for the suffering before I died – loss of hearing, chronic pain, a knee replacement, and more. Aging as a Spiritual Practice – A Contemplative Guide to Growing Older and Wiser profoundly impacted my approach to aging.

Buddhist priest and meditation teacher Lewis Richmond offers “an inner road map that reimagines aging not as a time of decline, but as a time of fulfillment that can, in spite of occasional indignities, be something to enjoy.”

Beginning with “Lightening Strikes” – the moment we awaken to the fact of our aging (mine was needing hearing aids), Richmond uses individual stories, including his own experience of encephalitis to present topics such as Chapter Four -"I Like Growing Old,"- in which his friend Stephanie says, “Let me tell you how getting older is for me. I’m fifty-three and I love being the age I am! I’m doing a job I really like, I can wear what I want, and I don’t have to worry what people think! I’m grateful for the life I have now.”

In Chapter 5 - “I Don’t Like Growing Old,” some of the comments were: “I have less energy, physical, sexual, and emotional.” “People I know are getting sick and dying.” “I’m stuck with what I’ve got.”

Lewis Richmond is the author of five books: the national bestseller Work as a Spiritual Practice; the award-winning Healing Lazarus (a memoir of his experience with and recovery from a rare neurological disease); and most recently, the highly praised A Whole Life’s Work, a sequel and companion to his first book, and the award-winning Aging as a Spiritual Practice.  

Richmond's writing is conversational, as when he writes, “Reframing” is a bit more difficult to define, but basically it means to shift your attitude about a situation from pessimistic to optimistic—in other words, the power of positive thinking. It really works!” He is a master storyteller. I could see the similarities between myself and the people he encountered. A feeling of compassion and understanding underlies his interactions with them.

Richmond explores what medicine and science know about healthy aging – and why women are more skilled at it. “Realistically, because they go through menopause. When it comes to realizing they’re aging,” one doctor said, “women drop off a cliff, so to speak, while men the same age either ignore the signs or notice them a lot more gradually.” “Another gender difference is that women tend to use humor more in dealing with aging, while men—once they get past their denial—prefer serious data and hard facts. Women form support groups around their emerging interests—a book group, a gardening group, a hiking or bird-watching group—that can also serve as a forum in which to discuss age-related issues and problems, physical and otherwise.”

The chapter with the most significant impact on me was "Conquering the Five Fears." Presenting Fear of Death, Fear of Illness, Fear of Losing One’s Mind, Fear of Loss of Livelihood, and Fear of Public Speaking. Yes, public speaking! He says, “These five fears are called “great” because each of them can cause panic and trigger the autonomic nervous system. The prospect of death, illness, losing one’s mind, losing one’s livelihood—and yes, even speaking in front of a crowd—can cause panic.” He presents some strategies for approaching these fears.

At the end of each chapter, Richmond invites the reader to try various contemplations related to the material. For example, identifying our emotions related to aging or taking a gratitude walk. Many include visualizations, a powerful tool, or guided explorations of thoughts and emotions.

Richmond touches very lightly on his Buddhist practice. The reader is not asked to believe anything, but see an offering of something to try as we live at this stage of constant change. He says, “To practice ahimsa (non-harming) is to follow Buddhist values, whether you call yourself a Buddhist or not. Meditation grows out of the ahimsa spirit and is a central expression of it. The application of Buddhist meditation to aging, as we are pursuing in this book, is another application of the ahimsa spirit. Our increasingly fragile and infirm bodies and minds are sacred and worthy of the greatest kindness and care. To respect our aging at every stage is the greatest kindness we can offer to ourselves and those we love.”

I use this brief meditation from the chapter “What Buddhism Teaches” daily: “As I grow older, may I be kind to myself; As I grow older, may I accept joy and sorrow; As I grow older, may I be happy and at peace.”

In the final section, Richmond offers "A Day Away." This daytime self-retreat is presented with straightforward hourly instructions for a journey of self-discovery. He concludes the book by saying,“Hold on to the underlying principle of all we have learned here: to remain aware and awake, regardless of what is going on. Many of our strengths and faculties decline as we age, but our ability to pay attention can be practiced through the contemplations in these pages, and can persevere and even grow. As the Buddha said so long ago, “Don’t believe it because you have read it or because I say it. Believe only because you have tried it and found out for yourself that it is true.”

This is a book to read slowly and savor. Repeated investigations of the contemplations reveal new insights and bring comfort to the aging process.

It happens. There is nothing to fear here. - Maureen Hirthler

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Maureen Hirthler is the Managing Editor of the Intima. She holds an M.F.A. in Creative Writing from UMKC and studies Buddhism.