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Jessa CrispinBack to OpinionJessa Crispin

Joanna Kavenna on the labor of ‘Birth’

It’s one thing to be writing about a historical figure in nonfiction — the responsibility you bear to tell the truth from all angles, to do it in an entertaining yet respectful manner, to give the true essence of the person. That person is meaningful or important in some way, and your work is going to influence, even if only slightly, her or his reputation in the future. It’s quite another to drag a real person into your novel, to make them do or say things they never did in their lives, to use them as a character. It’s why so much historical fiction is awful — Anne Boleyn becomes a paper doll, used for cheap erotic tension in a bodice-ripper. Or poor humble, dignified Abraham Lincoln is being made to hunt zombies or vampires or whatever it is.

But some writers are able to use real-life characters in their novels in a way that heightens both the book and the person. So Charles Darwin becomes a funny, wise, rum-swilling imaginary sidekick in Jillian Weise’s fantastic “The Colony,” and medical hero Ignaz Semmelweis — who discovered the cause behind the scourge of childbed fever, which killed untold numbers of women in childbirth — becomes the tragic anchor to Joanna Kavenna’s moving new novel “The Birth of Love.” I asked Kavenna to elaborate on the pitfalls and strengths of pulling obscure stories from history to frame a novel, how to balance the truth of the historical figure and the fictional character, and how she tied it all together.

My father was in medicine, and so I grew up hearing about Ignaz Semmelweis (probably some sort of emotional manipulation about washing my hands before dinner). But it’s not as widespread a story as one might think. When did you first learn about his life?

Before I got pregnant with my first child, I didn’t know much about Ignaz Semmelweis. I had a vague notion that he had been right about the causes of childbed fever, and had been generally ignored by his contemporaries. But once I became pregnant, I started reading through histories of pregnancy and childbirth, and found his story again. I thought it was extremely compelling and sad. Hungarian by birth, Semmelweis was living in Vienna in the 1840s, working in the General Hospital there as an obstetrician, and he began to realize that childbed fever, a fatal scourge at the time, could be prevented if doctors washed their hands. He argued that childbed fever was being spread by doctors who had performed autopsies on women who had already died of the disease, or who were examining one living woman after another, without washing their hands in between. He was mostly dismissed. Some of his colleagues were outraged, indignant, accused him of suggesting they were not gentleman, that they were “unclean.” Others simply didn’t take any notice of him, and had other theories about the causes of childbed fever, such as inadequate ventilation, which they preferred. Semmelweis returned for a while to Budapest, and put his theories into practice with great success there. But elsewhere, including Austria, he failed to win his colleagues over, and countless women continued to die because doctors wouldn’t do this small thing, even on the off-chance that Semmelweis was right. Partly it was professional arrogance, that impulse among self-appointed elites to reject novel theories, to assume the “established” way of doing things is inevitably right. And Semmelweis became increasingly vehement, and frustrated, started railing against his colleagues, calling them murderers of mothers. So then they condemned him as “unscientific,” “unstable” and so on.

So it struck me as such a powerful story with so many elements: this one man getting it absolutely right, but failing to be heard, and the legions of anonymous women, who had just been through the agony of birth, had managed to deliver a healthy baby, had thought, perhaps, they were through the worst, and then, a couple of days later, developed this terrible disease. And the doctors who would not change their minds.

I was pregnant, as I said, and I was also looking for a way to write about the moment of birth, about the sense you get at that moment of ages stretching before and after you, all these billions of lives, birthed in the way you have just birthed your child, and the wonder and downright shock you feel, and also the overwhelming protective love. I wanted to write, too, about how central this experience is to human life. Birth sometimes gets dismissed as of interest only to women, which strikes me as odd, because we all come from this moment of birth, and men and women, equally, feel this unconditional parental love. So I wanted to write about birth in different places, and societies — in the past of Semmelweis’s Vienna, and in the present, in London, and in a technocratic future…

Does writing about a real-life person in a fictional context change the way you write? Say, in comparison to a purely fictional character?

One thing I am always interested in grappling with in my writing is the question of truth. Who decides what is truth? Why does anyone believe them? With “The Ice Museum,” my first book, I wrote about a myth: a land in the remote north, called Ultima Thule, that may or may not have existed. I wanted to look at all the stories upon stories that had been told about Thule, and the elision of truth and fable that had characterized everything written about it, and really how in discussion of Thule, the divisions between fact and fiction became permeable. With “Inglorious” I was looking at one person who decides the “truths” she has been given — work hard, you will be happy; buy a flat, happier still; subscribe to the consumerist ideal, why not? — are meaningless … effectively other people’s “facts” become fictional to her. So she does something very hard — she tries to find her own way of living …

With Semmelweis, I was fascinated by the idea that he was absolutely right, and yet everyone else thought he was completely wrong. Eventually he was diagnosed as mad — he died in an asylum. Yet really all the doctors who condemned him so confidently were stark raving bonkers, because they were so absolutely convinced of their own rightness. And they were accepted as the grave and certain authorities of the time, even though it turned out that they were a load of ignorant fools.

So it was crucial for me, in telling Semmelweis’s story, to play a bit with ideas of “truth” and “untruth” and authorial authority. (I must emphasize, though, that this wasn’t meant to be “postmodern” — I think things are MUCH weirder than that…) My novel opens with a section called “The Moon,” where we meet Semmelweis, who is being interviewed in the asylum by a man called Robert von Lucius. Robert von Lucius is a completely fictional character; he never existed. Later, we meet a novelist in contemporary London, Michael Stone, who has just published a novel called “The Moon,” about Semmelweis. The Semmelweis sections are really excerpts from Michael’s novel. They are written in a kind of literary pastiche; I wanted to write the 19th-century as I imagined Michael Stone would — gothic, very dark, Edgar Allen Poe, M.R. James, Charles Dickens. We are told in the history books that Semmelweis went mad, or at least was confined to an asylum. It’s uncertain what the real nature of his madness was. Michael Stone makes it a sort of dementia, in which Semmelweis forgets everything except the details of his battle to have his theories about childbed fever accepted. He can’t remember much about the recent past, he is very disoriented, but the details of his professional struggles are completely clear to him….

I wanted the tragedy of Semmelweis’s story to come through: his incredible visionary realization about the way to prevent childbed fever, and the huge human loss bound up with all those poor mothers who died and their abandoned children, and the wages of professional arrogance. Then I was interested in something about how scientific absolutes are created — that the personality of Semmelweis was such that his theories were not accepted, whereas Pasteur, for example, was able to promote his ideas and gain general acceptance for them.

And also I wanted to look at how we constantly interpret events — present-day and historical — in line with our own anxieties or beliefs. How subjective we are ourselves, even as we look at the subjective misjudgments of the past…

How do you balance the fiction and the reality? When do you know it’s time to stop doing research and start playing around with the character?

I did a lot of reading into medical history and the life of Semmelweis. Some particularly crucial books were “The Etiology, Concept and Prophylaxis of Childbed Fever” by Ignaz Semmelweis, translated by K. Codell Carter, “The Doctors’ Plague” by Sherwin B. Nuland, and “Childbed Fever: A Scientific Biography of Ignaz Semmelweis by K.Codell Carter and Barbara R. Carter. And Clare Hanson’s “The Cultural History of Pregnancy.” I read a lot and then put it all aside. Then I turned to something else for a while, some months even. As above all I wanted to find a way to write about Semmelweis which seemed to fit the details of his character and story … It was only when I had the idea of placing him in a novel within a novel, that I could really let fly.

For me this is one of the wonderful things about being an author, that in your books you get to create your own universe. It may look like the world that we all live in, in certain respects, but really it’s entirely your own fictional variant and you can do whatever the hell you like, so long as you can persuade your readers to come with you. So I thought of Michael Stone, my author, writing his novel. I imagined him every day, sitting there in his apartment in a tower block in south London, with his desk and his piles of books about Semmelweis. I thought he would be incredibly nervous, fastidious. (He is a nervous, self-doubting man.) Very eager to get it all right. He is childless, single. He writes for hours and hours each day. He has a fixed routine — he starts at dawn, he breaks for lunch, then goes for a walk in the afternoon. He returns to his manuscript in the evening. Everything about his writing process was unlike mine. So I loved all of this, imagining this world in which Michael Stone has written his a novel and called it “The Moon” (even though people keep telling him this is a dreadful title!).

Then there is a woman, Brigid Hayes, who is in labor in contemporary London, struggling to birth a child. She goes through an ordinarily apocalyptic labor, and she needs all her strength simply to get through. And then in a future world there is a woman who has concealed a pregnancy simply so that she can give birth without masses of technocratic intervention, because her society has become hostile to nature, entirely convinced they can improve on everything “natural” through “science.” So she has insisted on defining the conditions of her pregnancy and birth, even as her society tries to shut down choice, make everyone conform to a set, “scientific” way of doing things. For me these four narratives — Semmelweis, Stone, Brigid Hayes, the future — were all equally important, and fed into each other. In the final stages of my book I mixed these worlds together. I wanted it to be as if a worm-hole was forged in my novelistic world, and everything was happening in the same moment …

So, to answer your question, I never quite know when it’s time to start playing with characters but basically I read a lot, for years even, and then suddenly things start to happen, weird coincidences occur, sudden moments of claritas, however fleeting, a sense that something might have germinated, and then I start writing and hope the damn thing comes through.