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My first introduction to Caroline Leavitt was several years ago in a private writers’ Facebook group where members were raving about not only Leavitt’s chops as a writer, and her generous wisdom as an editor, but the seemingly boundless magnitude of her heart. I was intrigued. Slowly I began reading my way through her work and was spellbound by the precision of her language, the propulsive thunder of her plots, her vivid, particular insights, and the way tenderness haloed every cell of her worlds—even the tough stuff.

All of this carries through in her latest novel With or Without You. On the brink of a comeback, rock musician Simon encourages his girlfriend Stella to celebrate a little too hard. Stella, a nurse who knows better than to mix drugs with alcohol, does so anyway, driven by a yearning to revive a love and life that that had long been lost to her. Rather than a revival, Stella first slips into a months-long coma and then comes the other side with a whole new set of yearnings, ones that surprise her, along with a staggering artistic talent that forces her to honor this new version of herself even if it means she has to leave behind things she loves.

Leavitt is no stranger to comas. After giving birth to a healthy baby boy, a rare blood disorder caused her to hemorrhage so severely she was put into a medically induced coma for three weeks and underwent numerous extensive surgeries. Given memory blockers to ease the trauma, Leavitt spent several more months in hospital before finally returning home to her husband and son with her dramatically altered body.

This isn’t Leavitt’s first time channeling her experiences into her work. 2003’s Coming Back to Me’s Molly’s experience more closely aligns with Leavitt’s. Slipping into a coma after giving birth, she too remembers nothing. Leavitt found this novel actually fed her triggers rather than provided any solace. So Leavitt decided to write about a woman whose experience was the opposite of hers; a woman whose life was actually improved by the coma. And hence Stella was born.

Caroline Leavitt and I chatted over Zoom about quantum physics, the miracle of our bodies, and what it means to be healed. As it turns out, the rumors were true, her heart and wisdom do seem to know no bounds.

 Jane: Like Stella, you were in a coma for three weeks. As you were coming out of it, you had the distinct impression that “This is like The Matrix and my other life was a lie.”  Stella also wonders if “everything she had lived before was a fake world.” I found that really fascinating. Could you could talk about this experience of these dual realities?

Caroline: Quantum physics says that time is a man-made construct, and that eventually it’s going to stop. I remember when I woke up in the middle of my coma, I had this sensation that everything before this was not real. And this is real. I felt that I was in a high glass, steel and concrete building. I could hear a laugh track and I thought, I’m in a TV show and there are people walking around. It was very vivid. As vivid as me sitting here and talking to you. I just felt I can’t move but I have to. This is a nightmare and I have to get out of it. And I didn’t know if anybody from my other world was going to be with me. I was terrified. And then a woman came over to me, I guess she saw that I was awake, and gave me a shot. I went under again.

For Stella, I wanted it to be a little different. I did want her to move away from her past world into a new world. But I didn’t want it to be as traumatic as it had been for me. So I did a lot of research. I talked to Joseph Clark at the University of Cincinnati and he told me that when people are in coma your brain is firing and rewiring, and things are changing. He said they don’t know exactly what happens, but some people come out with totally different personalities. Angry people can come out very peaceful. And a lot of people come out with sudden new talents. There’ve been cases of people who’d never spoken a language and they’re speaking fluent Mandarin. There was one woman who asked for a violin repeatedly. And her family said, “Why? You don’t play violin.” They finally got her one and she was a virtuoso and started playing concert halls.

They don’t know where that comes from. It could be from cellular memory from generations ago. Or it could be changes in the brain. Whatever it is, I thought, that’s incredible. And it made me wonder what else the brain can do. We construct our realities and we live in those constructed realities. But what if there’s something different?

Jane: Stella doesn’t go back to her former life. Did you return to your former life?

Caroline: Not totally. It’s very funny for me to say but the coma was a kind of gift to me because it really changed me in a lot of ways. I used to be a very shy introvert, and I became much more extroverted. I still was on all these funky meds for a year and they made me look really bizarre. I was on massive doses of steroids. I was huge, like a circus lady, and my hair fell out. My skin turned gray; even if I put makeup on, makeup on gray skin is very weird. We had no money and our medical bills were in the millions. My husband had lost his main gig because he was spending too much time with me and our baby. I had a friend who worked for Victoria’s Secret and I used to write catalog copy. I called her and said, “Do you have any work for me? We’re so desperate.” With those catalogs you can get ten or fifteen thousand just for writing about blue sweaters. So she said, “Yeah, I have a project for you. Come on in.” And I said, “Look, I can’t come in because I’ve been really sick. I’m okay now, but I look a lot different.” She laughed, and said, “Don’t worry about that, that doesn’t matter.”

So I wear a muumuu, that was the only thing that fit me. And I put a kerchief around my hair. You could tell something was wrong. I tried to put on makeup and it looked terrible. I got on the subway, and immediately there were four teenage girls all highly fashionable, and they were snickering at me. I got to Victoria’s Secret and everybody there is twenty-years old and beautiful, with rivers of hair and glowing skin and tight little dresses. And here I am in a muumuu and kerchief. As my friend came out, I saw her face drop. She walked over to me holding work in her hand and said, “I’m so sorry, I cancelled the project. I should have told you, but best of luck and blah, blah.”

I remember walking out and my husband, Jeff, was waiting for me. I was really upset. And Jeff said, “You know what, fuck them.” We were walking by a store and there was this skinny, little sundress. And Jeff said, “Do you like that dress?” And I said, “Yeah, but I can’t wear that. My arms are too big.” And he said, “Yes, you can. I bet you’ll look great in it.” So he talked me into going in there. And I bought the dress. And I wore it. And every time I said, “My arms are flapping,” he’d say, “no, they’re not. You look fine.” When people looked at me, he would look at them and they’d back off. That changed me. It’s really hard not to be sucked into what people look like especially in New York, but after that day I pulled out of that. I began to realize not only doesn’t it matter, it’s wrong.

What I started to do is when I would walk in the streets, I made it a point of finding someone who looked like they really needed a compliment. Usually, it was old ladies who had taken the trouble to dress nicely. I would walk by them and say, “Oh, you look really nice.” And they would get radiant. And I thought, well, that’s much better than walking around worrying about whether you’re wearing something that the New York City fashionistas are going to approve of.

The other way that the coma change changed me is I have a real sense that any moment anything can happen. It can be something good. It can be something bad. So I’ve told myself that the moments that I have left, I’m going to be the kindest I can, work as hard as I can, be as loving as I can. And not worry about the stuff that I’ve always obsessed about, things like fame, and who likes me and doesn’t like me. All this kind of stuff that I feel is ridiculous now. And I’ve become calmer. I used to be upset about everything. In that way, it’s been it was a real gift for me.

Jane: Did your experience leave you a more empathetic person? It sounds like it did. Or did if it leave you more fearful in anyway?

Caroline: No, I’m not afraid of anything anymore. I used to always worry about what should I say and if I say something wrong are people going to think I’m stupid or whatever. When people are showing me that they’re sad or something’s terrible, in the past I would try to rush in and fix it. Now I rush in to listen. I think a lot of times people just want you to bear witness and just be there.

Jane: Both you and Stella have the experience of feeling disconnected from your bodies. What is your relationship like with your body today? Did the coma strength it or weaken it?

Caroline: When I was in the coma, they didn’t know what I had, they just knew I was filling up with blood. So they did these five emergency operations. Nobody thought I was going to survive so they really made a mess of my stomach; they cut muscles, my belly button that was over on the right. I have scars up here. And scars across here. And I’ve indentations from the drains. When I got home, I had to learn how to walk and do all this stuff. But I was so happy that I was here, and I had survived. And there was my baby. So I began to look at my stomach differently. I could never wear the tight clothes I’d worn before because my stomach is sort of triangular. But I began to see it as a medal of honor.

A few years passed and the doctor said, “If you wanted to repair your stomach, you could.” And I thought about it, and I realized I didn’t want to because this is the body that got me through what it got me through. I look at these scars and I see badges of honor. My husband has been great about it. He will look at those scars and say they’re beautiful.

Jane: I love your husband.

Caroline: Oh, he’s wonderful. Even when I was bloated and had no hair, he always made me feel beautiful and desirable. And that things were going to be okay. And that that helped a lot.

Jane: America is living through such tumultuous and traumatic times now. Has what you’ve lived through provided you with any particular coping skills for times like these?

Caroline: It has actually, because I know that feeling of fear and worry over what’s going to happen next. And I have learned that you have to stay in the moment and not project too much. I had a nurse I loved when I was in the hospital. She came in when I was panicking because they wouldn’t let me go home; they kept saying you have to another three weeks and then another three weeks. And this nurse came in in the middle of the night when I was really upset, and she said, “I’m going to give you a gift. What you have to tell yourself is start small. Do you think you can get through the next ten minutes?” And I said, “Yeah, probably.” She said, “Okay, so that’s all you’re going to do. You’re going to take life at bite sized and once you get through the next ten minutes you going to acknowledge that and then get through the next ten after that.” So that’s what I do now. I don’t want to ruin the moment I have now, by going into a fantasy about what it’s going to be like, if I or someone I love gets COVID.

I’ve had enough terrible trauma in my life that I know what can work and what can help. And I also know a little bit more about how to help others. As much as people don’t want to go through these terrible things, it really helps to be a better person in a lot of ways.

Jane: You wrote an essay about being in a coma for The Daily Beast, at the end of it you write: “And in the end, creating her [Stella], writing her experience, made all the difference for me. In the end, that was what healed me.” Can you talk about how this happened? And what does being healed mean to you?

Caroline: Well, that’s another great question. The first novel I wrote about my coma, which was directly after the coma, was very much based on me. It was sort of dark, because I was feeling dark at the time. There wasn’t a lot of hope at the end of the book, it just ended with Molly, the woman who was like me, not knowing if she was going to get better. And I didn’t feel better after writing that book.

When I wrote Stella, because she actually was better in so many ways, I just felt like thanking her, because her journey made me feel a whole lot better, and made me feel that tragedy is not always tragedy, because there were things that come out of it, that can give you better things and richer things. And I just loved her so much. It really felt to me like she was leading me by the hand saying, “look, this is okay, now. You went through that, but there are new things, and let’s move on and look on to the future.” When I finished the novel, I felt like, Oh, I don’t have to write about coma ever again. And that was kind of a nice thing, because it made me feel Okay, I’ve processed that. Now I can write something else.

Jane: So is that what being healed feels like to you, that you don’t have to keep processing that experience anymore?

Caroline: Yes, because I would keep processing and processing and thinking about it and worrying about it. And things would set me off. If I saw a soda that I had when I was in the hospital, I would panic. And now, the only vestiges of the coma that I have left is that I don’t like going to sleep. I’m very afraid of that.

Jane: Well, that actually ties in with my next question. Stella develops an understandable fear of going to sleep because she’s afraid she won’t wake up again. I think post-illness PTSD is more common than we realize. Do you have thoughts on this?

Caroline: Your body definitely remembers. I had gone to a therapist, and I felt like my mind was okay, but my body kept reacting and reacting and reacting. There’s muscle memory. It’s not like your mind; you can’t talk it away. So then it just becomes a question of how I was going to handle it. Writing about Stella helped a lot. And as I said, the only thing that I’m still not quite sure what to do with is the whole thing about going to sleep. I’m very afraid that I’m going to go to sleep and I’m not going to wake up. The only way I get around that is if I can make myself so exhausted, I will sleep. I don’t want to take sleeping pills. I tried melatonin. It didn’t really work. I tried wine that didn’t really work. Plus, I woke up feeling terrible. So it’s a process. I always think everything has a cost: happy things, sad things. The happy thing is that, okay, I’m alive. Nobody thought I would live. Twenty-four years later, I’m fine. And I’m healthy. And if the cost is that I have to grapple with this fear of being asleep, then I’m going to deal with it.

Jane: Growing up, Stella’s parents had been “bohemians” and hadn’t provided her with much security, often not having enough money for the electric bill. As an adult, Stella became a nurse because “she had never wanted to be that scared again.” Yet, of course, she is that scared again; possibly more so. What are your thoughts on safety and security? Are such things possible? If not, how do we stay sane amidst the fluctuations?

Caroline: That’s a really good question. For me, it comes down to stopping the panic before it starts. It’s actually something I learned in cognitive therapy. You can’t catastrophize. Say you don’t have money for the rent. And you say, “Okay, I’m going to get a job to make sure I have steady income.” And then that job fails. You can start catastrophizing and think, “I’m never going to get another job, and I’m never going to be happy.” I try to be in the moment and say, “Well, has that happened yet?” The answer is usually no. “Has it ever happened in your life that you’ve never been able to get a job and that you are on the verge of being homeless?” No. “Do you have skills?” Yes. “So you could get a job if you wanted to.” Yes. It’s a series of practical questions that I ask myself so I don’t fly off the handle.

Jane: Libby, Stella’s friend and doctor, ruminates about a plane trip where a man had suffered a severe asthma attack. She rushed to help him, only to be pushed aside in favor of a male paramedic. And during her hospital rounds, she faces daily misogyny. Despite strides forward, this is a common experience for women in most professions. And now during the pandemic, with so many children home, women are having to set aside their careers to keep the home front running. What was it like to write a character like Libby who is brilliant and capable and yet undermined simply for being a woman?

Caroline: I loved writing Libby. I talked to a lot of female doctors because I wanted to be sure that this still happened and they had story upon story upon story where every female doctor has to be twice as good as their male counterparts. A lot of people would say, “I want a real doctor,” when a woman doctor would come in. The women would say, “I am a real doctor. Do you want to see my credentials?” It didn’t matter whether they had gone to Harvard med school. People always preferred the males.

It’s in every profession. It’s less so in the literary profession, but it’s still there. If you write about a domestic drama, then it’s women’s fiction. But if a man writes about a domestic drama, then he’s Jonathan Franzen and it’s brilliant and look how well he knows women. And he doesn’t know women at all. It’s just a male version of what a woman is.

I think it’s a constant battle for women to keep saying, “you’re wrong, and we’re going to keep going forward and sooner or later, all these bad, stupid feelings will die out and women will prevail.” It’s terrible in medicine. Women doctors are not given the opportunities that male doctors are. People who are the chiefs of staff are male, male, male, male. I wanted to write about that.

Jane: Listening to you, I’m thinking how we’re so thrilled about Kamala, and it is thrilling. But we haven’t even had a woman President yet. We’re thrilled just to get to Vice President.

Caroline: I know, I know. The scary thing is when you think of somebody like Hillary Clinton, who could have been president, there were a lot of women still who weren’t ready to accept that. My sister and my mom, both did not like Hillary. And I kept saying, “Why not?” And it boiled down to, she’s too strong. And I said, “Well, don’t you want a strong woman?” Or they’d say, “She’s not nice.”

Jane: Look who we ended up with! Not nice! Ugh.

Caroline: I know. It’s so bizarre. So there’re a lot of women who do not help that at all. I got to know the nurses really well at the hospital, and I loved them. And a lot of them would tell me that they were the ones who really knew the patients. And they were the ones that really advise the doctors. I would say, “Well, do the doctors listen to you?” And they would say, “if it’s a woman doctor, always. If it’s a male doctor, they would get upset, ruffled feathers about it.” And I thought, Wow, that’s really ridiculous to have that going on now, but it does.

Jane: The more Stella embraces her new talent of painting, the more her psychic abilities awaken. Do you think we all have these abilities and have lost touch with them?

Caroline: Because I believe in quantum physics, I don’t think there’s anything really woo-woo about talented psychics who have intuition, or can read things, or can tell certain things. I truly think that thoughts are energy, thoughts are out there in some form, and talented psychics can pull that out and see it. And I didn’t want Stella’s talent to be seen as anything woo-woo. I wanted her to be seen as, well, her brain has changed and maybe she can go into a parallel universe and tell what’s going on, or she’s just more intuitive. People don’t listen to their intuition. There’re a lot of times when you have a gut feeling about something and you don’t follow it, but if you do, then that can be opened up.

I’ve had moments in my life where I’ve known things. When I was really young, I was engaged to this guy, and I used to tell my friends. “I know he’s going to die.” And they would say, “Oh, come on, what are you talking about?” I knew he was going to fall off his couch and die. My friends would say, “You’re ridiculous.” The night before he died, I had a dream that was really disturbing, and I told him about it. He said, “Oh, you’re just nervous about the wedding. We’re getting married in two weeks.” And the next day, he died. He had a heart attack and fell off the couch. So I kept thinking, How did I know that? I mean, that seems like a little close. But maybe it was in the atmosphere, and I was able to pull it out.

Jane: Even as Stella evolves into a more independent, creative, and true-to-herself woman, she longs for who she used to be, who, in part, was someone living her life to please others. It’s almost as if she feels guilty for leaving behind the people who weren’t truly supporting her. I think women in general struggle with this, even if it doesn’t involve an illness.

Caroline: You know, as soon as you said that, I thought, oh my god did I do that and then I realized I most certainly did. I grew up in a family where I was the people pleaser and the fixer of the family. I was the Pollyanna and it was really important to me that everybody be happy, and everybody be loving, everybody liked each other. My sister had this terrible personality change when she turned seventeen. She became very hostile to me to the point of viciousness. I went to my therapist said, “What can I do for her? What can I do for her?” And the therapist said, “Well, you know what, you might have to do something for yourself, which is to separate yourself from that viciousness. Just say something like, I love you, I’m here, but I’m going to live a happy life. And now the happy life might not include you.” And that’s what I’ve had to do. It was a terrible decision, but I feel much better, because I’m not getting screaming phone calls. I’m not getting things that I’ve sent her returned to me all ripped up. But I do feel a yearning that like, Oh, if only I could help her because that’s what women are trained to do. But sometimes you have to realize that you have to save yourself and live your own life. I’m not harming her life. I’m just saving mine.

Jane: The novel ends on such a positive note. Toward the end, Stella says, “We all have multitudes inside of us, each of them young with hope. Any moment, something amazing can happen.” Do you share Stella’s optimism?

Caroline: I do. Because I have seen myself change. It wasn’t easy. I grew up intensely shy and fearful. I would never tell anything dark or any secret. When I went on book tour, I had to learn to speak to people. I began to carry talismans. I had red cowboy boots, because I thought any woman who wears that is kickass and brave. And when I wore them, I felt that way. And I began to experiment more. I would tell people deep emotional truths that embarrassed me just to see what would happen. I learned that people opened up more to me when I did that, and I became more and more emotionally honest.

I started writing more essays saying, this is what happened to me; this is this is the truth of it. And it felt so freeing, because my mother would always say, don’t talk about family, never say anything bad about your sister or your father. And I thought, well, how can I heal if I don’t mention that? And I found that writing about it made me feel more connected to the world. And I also feel that’s the way I want to live. And I don’t know what else I’m going to do or be, but I love the feeling of being brave. I do feel that we can change. We can have these amazing lives. It does take work, and it does take pain. But it’s like in writing, you learn to sort of like the pain because of what it can teach you.

Caroline Leavitt is the New York Times and USA Today bestselling author of Cruel Beautiful World, Is This Tomorrow, Pictures of You, Girls In Trouble, Coming Back To Me, Living Other Lives, Into Thin Air, Family, Jealousies, Lifelines, Meeting Rozzy Halfway. Her essays have appeared in Salon, Psychology Today, The New York Times Sunday Book Review, Modern Love, among others.

Jane Ratcliffe’s work has appeared in The Sun Magazine; O, The Oprah Magazine; Creative Nonfiction; Longreads; Guernica; Vogue; New England Review, and The Believer; among other publications. She holds an MFA from Columbia University. She lives in Michigan with two cats and a dog.

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Verge, by Lidia Yuknavitch, is out in paperback. These short stories will grip your heart and mind.  The writing is sharp and the empathetic portraits of broken people will stay with you long after you finish the collection.

If you haven’t already, pick up a copy at Bookshop.org or Amazon.

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Anti-racist resources, because silence is not an option

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