The nature of phantom limb pain has bedeviled amputees and bewildered physicians and surgeons for centuries; up to 87% of amputees experience it during their lifetime. Consistently effective treatments remain elusive. Biomedical texts on the subject are at once complex and speculative. Olga Tokarczuk, in her 2018 novel, Flights, imagines what phantom limb pain could be like for someone, and the desperate search for relief it can produce. 

Flights centers mostly on the narrator’s travels among different places and across different times. It comprises mostly packets of individual story vignettes and fragments; some short, some long; some fictional; some real, some both. And though many different stories are told with many different characters about many different subjects, something about travel connects them all.  

Certain preoccupations manifest themselves in various parts of the book. One in particular concerns the technical aspects of preserving human body parts, which comes into play in a story fragment involving phantom limb pain. The main character is Philip Verheyen, who is a real historical figure known as a renowned Flemish surgeon and anatomist of the late seventeenth and early eighteenth centuries, and as the author of Corporis humani anatomiae (1710).  

As Tokarczuk tells the story, Verheyen was twenty-eight-years old in 1676 during his second year of university in Leiden when he scraped his left calf on an exposed nail of the stairway leading to his rented lodgings. His pants were torn and his skin broken. Though the injury seemed minor at first, it evolved into a raging infection that later required below-the-knee amputation.  

With the care of his landlady, Verheyen recovered after which he was seen “tapping his peg over the uneven paving stones of Leiden,” to attend lectures on the subject of anatomy at the university medical center.” (p. 195) In a matter of a few weeks after the amputation, however, the pain started. 

The pains came at night as his body was relaxing and slipping across the uncertain boundary between waking and sleep…He would have the impression that his left leg was numb, and that he absolutely had to get it into the right position—he felt his toes tingling, an unpleasant sensation. He fidgeted, half conscious. He wanted to move his toes, but the unperformability of that movement awoke him completely. He would sit on the bed, tear the blanket off himself, and look at the aching place—it was some thirty centimeters below the knee, there over the rumbled sheet. He would close his eyes and try to scratch it, but he touched nothing, his fingers combed the void in despair, giving him no relief. (p. 203) 

In imagining how Verheyen could respond to his desperation for relief, Tokarczuk draws on his intense interest in preserving human body parts. Before the amputation, he begs the surgeon to “preserve the removed leg.” (p. 193) The surgeon followed Verheyen’s detailed instructions for preparing his amputated limb by placing it “in a glass vessel filled with a balm of Nantes brandy and black pepper.” (p. 193) Verheyen kept it “on his headboard or stretched scarily out on the table.” (p. 196) Eventually, he looks to it as a possible source of relief. 

Once, in a fit of despair, when the pain and itching were driving him mad, he stood and with trembling hands lit a candle. Hopping on one foot, he moved to the table the vessel with the cut-off leg [rested]…He extracted the limb and in the candlelight tried to locate in it the reason for the pain…He sat down on the floor, stretched his legs out before him, and laid the amputated limb on the place just below his left knee. He closed his eyes and groped for the painful place. His hand touched the cold piece of flesh—but could not reach the pain. (pp. 203-204) 

Verheyen’s maneuvers and observations did not provide him relief. With his medical training, he begins thinking about mechanisms that could be causing this excruciating and frustrating phenomenon. 

What is it that awakens me, when I feel pain and suffering, since my leg has been separated from me and is floating now in alcohol? There is nothing pinching it, no reason for its suffering, no such pain that can be logically justified, and yet it exists. Now I look at it and simultaneously feel in it, in the toes, unbearably hot, as though I were submerging it in hot water, and this experience is so real, so obvious, that if I were to shut my eyes, I would see in my own imagination the bucket of water overly heated and my own foot submerged from toes to ankle. I touch my bodily existing limb in the guise of a lump of preserved flesh—and I don’t feel it. I feel, meanwhile, something that does not exist, it is in a physical sense an empty place, there is nothing there that might give any sensation whatsoever. The thing that hurts does not exist. A phantom. Phantom pain. (p. 208)  

He comes up empty. 

Tokarczuk cannot imagine Verheyen would let the issue lie and accept it simply because he is without an anatomical or pathophysiological explanation. She knows that before he began his schooling in medicine, he was studying theology towards becoming a Catholic priest. In fact, in the book and in his real life, the amputation disqualified him from Catholic priesthood. So, Tokarczuk brings his theological training into thoughts he could have about this phenomenon that is torturing him from spiritual realms, and in this way leaving Verheyen to contemplate the mind / body relationship. He concludes, “The body is something absolutely mysterious.” (p. 209)  

It still is.  

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Shortly before the outbreak of The Great War, a young engineering student arrives at a tuberculosis sanitorium high in the mountains of Central Europe. Over the course of his visit there he will share many meals (and drinks) with some of the other patients, a group which will include among others a Catholic conservative and a liberal humanist; there will be long, leisurely after-dinner discussions of varied philosophical topics; temperature charts will be compared; and he will become intrigued by a mysterious woman who is also a patient.  

And no, this is not The Magic Mountain. 

The Empusium is the latest novel from the Nobel- and International Booker Prize winner Olga Tokarczuk. The author subtitles her book “A Health Resort Horror Story,” which is exactly what it is. But it is a horror story which the author has cleverly folded into not just the setting of Thomas Mann’s novel, but the setting and certain elements of the plotline, all of them slightly altered, but recognizable. In fact, recognizing them is part of the fun of this well-plotted, rather Gothic tale. 

As the novel opens Mieczysław Wojnich, a young Pole from Łwów, has arrived at the tuberculosis sanitorium at Gӧbersdorf, in Lower Silesia (currently Poland, formerly Prussia), to be treated for his illness. There is no room at the main building, so he is assigned a room at Opitz’s Guesthouse for Gentlemen, where he meets his fellow (male) patients, who come from various Central European cities and differing viewpoints, but who seem to agree on one thing: the general inferiority of women. Philosophical discussions, which often take place over or after leisurely meals and the consumption of a magic mushroom-laced liqueur called Schwӓrmerei, range widely over several topics (war, language, the nature of reality) but most of the time are intensely misogynistic—what is the purpose of women? Do women have smaller brains than men? Do women’s bodies belong to the State? Have any great discoveries ever been made by women? Should women even be educated at all? (Tokarczuk helpfully includes an appendix to the novel in which she notes that all of the quotes of her characters on this subject are paraphrased from quotes by well-known prominent authors of the past, from Augustine of Hippo to William Butler Yeats)  

Things at the sanitorium go badly from the beginning of Wojnich’s stay. He stumbles upon the dead body of a woman laid out on a table, who turns out to be the wife of the guesthouse proprietor, and his companions tell him surreptitiously that she may have been murdered. He hears noises—voices—coming from empty rooms, and cries in the night from outside the guesthouse. An art student who is terminally ill confides that “people die here,” and not just from tuberculosis; every November, apparently, a young man disappears in the surrounding woods, only to have his body turn up ripped to pieces. And what exactly is going on with those woodsmen in the forest, anyway? 

The Empusium works on many levels. It is an homage to The Magic Mountain, but it is definitely not a retelling of The Magic Mountain. The allusions to Mann’s novel are multiple: the pre-World War I setting at a sanitorium in both novels; the fact that both Mieczysław Wojnich and Hans Castorp are engineering students; the philosophies of Settembrini and Naphtha in the Mountain, analogous to the conservative and humanist positions taken in The Empusium; the close childhood relationship between Castorp and Pribislav Hippe (Mountain) and Wojnich and Anatoly (Empusium), in each case bonding over a pencil. And as in The Magic Mountain, there is a narrator who occasionally breaks the fourth wall; verb tenses in The Empusium shift repeatedly from third-person singular past tense to first-person plural present. These are not subtle, nor are they intended to be.  

Allusions aside, The Empusium is its own story, and a totally different narrative. It is a horror story, a revenge story, a wryly feminist tale of the supernatural set in a place hopefully of healing but also of chronic illness and the ever-present specter of death. Tokarczuk builds suspense slowly, bit by bit, with increasing tension. Almost from the beginning there is the undeniable sensation that something is very wrong at Gӧbersdorf, although it’s hard to pin down exactly what it is. Wojnich often has the feeling that he is being watched. The story line draws from a tradition of folk horror, and specifically from the notion that bad things can happen to “city people” when they are out in the country, among the “old ways.”  

The Empusium is also more than just a horror story, and an important aspect relates to the misogynistic attitudes mentioned earlier. Tokarczuk takes a position on the nature of male-female relations (perhaps the use of a sanitorium as the setting is meant to suggest that misogyny is an illness infecting educated society). In this book “civilization” seems to be identified with maleness, and maleness is located in the sanitorium and the guesthouse, a controlled environment with its dining rooms and drawing rooms and intellectual conversation—and in the medical world, since this is a facility for medical treatment— and it is here that women are demeaned. The forest, on the other hand, is the home of the Tuntschi, female figures created by laborers out of sticks and moss and other forest detritus. It is a place both beautiful and enchanting—and dangerous. Men venture into the (female) forest, and the forest—in the form of the Schwӓrmerei, which Wojnich describes as redolent of mushrooms, moss, and earth—is brought into the guesthouse; boundaries are porous. Male and female, the guesthouse and the forest each have their secrets…and Wojnich is the last to know. But Wojnich has a secret of his own.   

And the title? A word created by the author. Empusa, in Greek mythology, was a shape-shifting female spirit who seduced young men, drank their blood, then devoured them.  

The Empusium
Olga Tokarczuk 
Riverhead/Penguin Random House, New York, 2022 
302 pp. 

Web photo by Marek Piwnicki