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Hesitation Wounds
The acclaimed author of I Smile Back, Amy Koppelman is a novelist of astonishing power, with a sly, dark voice, at once fearless and poetic. In Koppelman’s new novel, Dr. Susanna Seliger is a renowned psychiatrist who specializes in treatment-resistant depression. The most difficult cases come through her door, and Susa is always ready to discuss treatment options, medication, and symptom management but draws the line at engaging with feelings. A strict adherence to protocol keeps her from falling apart. But her past is made present by one patient, Jim, whose struggles tear open Susa’s hastily stitched up wounds, revealing her latent feeling that she could have helped the people closest to her, especially her adored, cool, talented graffiti-artist brother. Spectacularly original, gorgeously unsettling, HESITATION WOUNDS is a novel that will sink deep and remain―like a persistent scar or a dangerous glow-in-the-dark memory.
192 pages, Hardcover
First published November 3, 2015
8 people are currently reading
966 people want to read
About the author
Amy Koppelman
9 books95 followersAmy Koppelman is the author of two critically acclaimed novels, A Mouthful of Air and I Smile Back. She received her undergraduate degree from University of Pennsylvania, and an MFA in fiction from Columbia University. Koppelman and her screenwriting partner adapted I Smile Back for the screen. The film, starring Sarah Silverman, premiered at the 2015 Sundance, Toronoto and Deauville Film Festivals. Amy lives in New York City with her family. She is an outspoken advocate for women’s mental health.
Amy would love to participate in your book club when reading her newest book - Hesitation Wounds.
For more info - amykoppelmanoffice@gmail.com
Amy would love to participate in your book club when reading her newest book - Hesitation Wounds.
For more info - amykoppelmanoffice@gmail.com
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Displaying 1 - 30 of 58 reviews
September 21, 2016
I was with a girlfriend of mine last night and we were talking about David Foster Wallace. "It's been three years since he killed himself," I said. And she said, "Yep." Waited a beat. "And he's still dead."
There are, I suspect, a tremendous number of the well-read who were deeply affected by the passing of David Foster Wallace and are still, in a variety of stop-start ways, attempting to process it. You can discern the struggle on occasion. There is a tendency to hoard the work, unread. To string out, over the lifetime that might have been his, each essay, short story, novel, interview - to have them (him) available (alive) in the world to encounter. Because while we had our journalistic reactions, our published collections, biographies and posthumous dissections, there is a part of the soul that is still young enough to scoff. Still pure enough to valiantly disregard. A part of the bright spirit the world hasn't killed yet that points to the grievous misread of Franzen's post-suicide squawk: "Does it look now like David had all the answers?" and knows it never looked to Dave for the answers. Knows as sure as sunrise and taxes and death that it looked to Dave for the questions. And if a guy who claimed to be his closest of friends can't see him, even now, perhaps he's mistaken as well in calling him dead. And what we need, what we opt for, what we content ourselves to imaginarily wait upon, is the man himself to resurrect and put the matter to rest. To say, hey, here is the question that, in my rush to get out of here, I forgot to leave you with. Sorry.
And you forgive him. And you take his question. And you let him go.
Amy Koppelman's Hesitation Wounds is a story greatly scaffolded by the particulars of the death of David Foster Wallace. Her protagonist, Susanna Seliger, is a doctor who specializes in electro-convulsive therapy for treatment-resistant depression. Her patient, Jim, had made the decision to go off his ancient brand of anti-depressant in favor of one of the newer formulations with fewer side effects. As sometimes happens, the new medications proved ineffective and his attempt to return to the old drug failed; it no longer worked. Electro-shock was the only remaining recourse. Jim, a writer, with a wife and a couple of dogs, ends in making a choice that sends his doctor spiraling back into her past and a grief she had never fully confronted or managed to work through.
The prose here is powerful, poetic...and merciless in its aggression. I was not prepared for this, and so had no real choice but to receive it all as a sucker punch. Painful. Unrelenting. Downright cruel in places. There are books, and I don't read many of them because I know my limitations, that make me feel like a masochist every time I consent to turn a page. I felt this here. That Koppelman manages to muscle her way to a hard-scrabble resolution deserves great praise. Unfortunately, I'm going to have to forgive her before I can tender it.
And this, it must be said, reminds me ever-so-much of Dave.
There are, I suspect, a tremendous number of the well-read who were deeply affected by the passing of David Foster Wallace and are still, in a variety of stop-start ways, attempting to process it. You can discern the struggle on occasion. There is a tendency to hoard the work, unread. To string out, over the lifetime that might have been his, each essay, short story, novel, interview - to have them (him) available (alive) in the world to encounter. Because while we had our journalistic reactions, our published collections, biographies and posthumous dissections, there is a part of the soul that is still young enough to scoff. Still pure enough to valiantly disregard. A part of the bright spirit the world hasn't killed yet that points to the grievous misread of Franzen's post-suicide squawk: "Does it look now like David had all the answers?" and knows it never looked to Dave for the answers. Knows as sure as sunrise and taxes and death that it looked to Dave for the questions. And if a guy who claimed to be his closest of friends can't see him, even now, perhaps he's mistaken as well in calling him dead. And what we need, what we opt for, what we content ourselves to imaginarily wait upon, is the man himself to resurrect and put the matter to rest. To say, hey, here is the question that, in my rush to get out of here, I forgot to leave you with. Sorry.
And you forgive him. And you take his question. And you let him go.
Amy Koppelman's Hesitation Wounds is a story greatly scaffolded by the particulars of the death of David Foster Wallace. Her protagonist, Susanna Seliger, is a doctor who specializes in electro-convulsive therapy for treatment-resistant depression. Her patient, Jim, had made the decision to go off his ancient brand of anti-depressant in favor of one of the newer formulations with fewer side effects. As sometimes happens, the new medications proved ineffective and his attempt to return to the old drug failed; it no longer worked. Electro-shock was the only remaining recourse. Jim, a writer, with a wife and a couple of dogs, ends in making a choice that sends his doctor spiraling back into her past and a grief she had never fully confronted or managed to work through.
The prose here is powerful, poetic...and merciless in its aggression. I was not prepared for this, and so had no real choice but to receive it all as a sucker punch. Painful. Unrelenting. Downright cruel in places. There are books, and I don't read many of them because I know my limitations, that make me feel like a masochist every time I consent to turn a page. I felt this here. That Koppelman manages to muscle her way to a hard-scrabble resolution deserves great praise. Unfortunately, I'm going to have to forgive her before I can tender it.
And this, it must be said, reminds me ever-so-much of Dave.
January 6, 2016
This is definitely not a lighthearted poolside read. It's also not likely to be a good choice for a book club. But that said, it's still pretty powerful. It's not so much a typical narrative as an exploration into the mind of someone dealing with loss as a regular part of her life. It feels very authentic and organic (even though that probably sounds kind of pretentious) and I really liked that about it.
The one downside for me is that the book is kind of choppy. It skips from what may or may not be the present to different times in the past and its hard to tell whats going on in any sort of linear flow like I am used to in a novel. But at the same time, this fits with the themes and ideas in the book since it deals a lot with memory. And of course the nature of memory is not a linear one. So while in some ways it was a challenge for me to figure out what went on when and where are we at now, one minute she's in her 40's with her daughter, then she's 15 hanging out with her brother, then she's in her early twenties with her boyfriend, and there is no sense of present or past tenses. It all kind of just flows from one to the next and back again. I don't think the story would have worked as well if it had been organized any other way. I definitely felt like it was an intentional and deliberate choice.
I love what she says about memory, that what we choose to forget is as important as what we choose to remember. It kind of gives the whole book a slant, makes you wonder how accurate what she is describing is versus how colored it might be by all the things that she has chosen to forget plus the distortion of memory over time and as it is influenced by emotion.
I could relate to the loss and grief and the insistent nagging of what if I had said ro done somethign differently, would it have changed anything.
I also liked the use of second person. It's not something you see very often and it doesn't always work, but it does in this book. Even though at one point she even says this is not a letter, it does have the feeling of an internal "conversation" which feels very natural and realistic. (I know I do it myself all the time)
Having experience with depression and loss myself, and having my own struggles with memories and grief, I could relate to this book which definitely added to my overall experience.
The one downside for me is that the book is kind of choppy. It skips from what may or may not be the present to different times in the past and its hard to tell whats going on in any sort of linear flow like I am used to in a novel. But at the same time, this fits with the themes and ideas in the book since it deals a lot with memory. And of course the nature of memory is not a linear one. So while in some ways it was a challenge for me to figure out what went on when and where are we at now, one minute she's in her 40's with her daughter, then she's 15 hanging out with her brother, then she's in her early twenties with her boyfriend, and there is no sense of present or past tenses. It all kind of just flows from one to the next and back again. I don't think the story would have worked as well if it had been organized any other way. I definitely felt like it was an intentional and deliberate choice.
I love what she says about memory, that what we choose to forget is as important as what we choose to remember. It kind of gives the whole book a slant, makes you wonder how accurate what she is describing is versus how colored it might be by all the things that she has chosen to forget plus the distortion of memory over time and as it is influenced by emotion.
I could relate to the loss and grief and the insistent nagging of what if I had said ro done somethign differently, would it have changed anything.
I also liked the use of second person. It's not something you see very often and it doesn't always work, but it does in this book. Even though at one point she even says this is not a letter, it does have the feeling of an internal "conversation" which feels very natural and realistic. (I know I do it myself all the time)
Having experience with depression and loss myself, and having my own struggles with memories and grief, I could relate to this book which definitely added to my overall experience.
November 10, 2015
A perfect book. "Hesitation Wounds" unfolds the uneasy, uncomfortable feeling of being alive through a story that feels like it has just the right amount of plot lines, characters, and length. We are a prisoner to the helplessness of our protagonist in the throes of her despair, but the fulfillment of the story is that we are just as assuredly driven to the resolution. We are passengers in this story about grief as assuredly as we are passengers in our own. When the ride is finished, you are not the same for the experience.
April 3, 2019
A chance to sit awhile and experience her sorrow and her loss. Amy Koppelman knows her way around just how to put all of that in to words. A very sad book that will resonate loud and clear for anyone who has lost their big brothers too soon. I put on Murmur and listened to the 6th song. I didn’t spin because I was crying too much. I miss my brothers.
January 20, 2016
loved it. sobbed at the ending ... it definitely brings your own memories to you as you read. Lyrical prose and choppy writing style made it difficult to follow at times, but that didn't stop me from wanting to continue on.
December 30, 2015
Well-written novels about mental illness are few and far between. There’s Prozac Nation by Elizabeth Wurtzel and the class The Bell Jar by Sylvia Plath. Many write memoirs. The best include Darkness Visible by William Styron. I met author Amy Koppelman through Twitter, an excellent source for connecting with authors. She sent me her novel Hesitation Wounds to read. I figured I’d be a strong match because I have depression and anxiety.
In Hesitation Wounds, a psychiatrist specializes in treatment-resistant depression. Sometimes meds just don’t work. When you’ve tried seemingly every medication and treatment plan with zero symptomatic relief, what can you do? You face despair and uncertainty. Dr. Susanna Seliger becomes the last resort for many troubled people. Of her practice: “When the MAOIs, TCAs, TeCAs, SNRIs, and SSRIs fail to get results, the patients are sent to me. And I zap ‘em. Or that’s what the movies would have you think. Electroconvulsive therapy (ECT), or, as it’s better known, shock treatment, is only shocking in that it doesn’t actually cause much, if any, physical pain. A patient’s emotional pain is an entirely different story.”
She makes every effort to avoid emotional attachment or involvement in how her patients feel but instead treats their symptoms. She maintains a professional detachment. She’s not there to talk and empathize. Dr. Seliger’s brother died and she feels quite a bit of guilt that she couldn’t save him. Koppelman elaborates: “You eternally seventeen. I try to figure out still. What I missed. Words I let pass, smells I didn’t recognize, unfamiliar tastes and sounds. Each an opportunity I failed to seize. Each a possibility to save you. Although now, so many years, so many patients later, I am aware that treatment is not without consequence, death without promise, visions without meaning. And handholding is merely that.” She now tries to save others from suicide. When a patient she allowed to break the emotional barrier [maybe he reminded her of her brother] commits suicide it throws Dr. Seliger into a spiral where she contemplates the relationship with her mentally ill brother and any warning signs she missed. Could she have stopped him?
“You can’t possibly know this because depression is an insidious disease. Robbing you of forethought, it makes you a reactive participant. Witnessing the world through the distorted prism of carnival glass leaves you feeling betrayed. The cruel nature of beauty. The unremitting groan of loss. You close your eyes and see him, cover your ears and hear. But that doesn’t excuse your actions. You should have said goodbye, Dan. Or at the very least let me know you had to go.”
Mental illness and its aftermath aren’t blatantly glamorized on these pages. The words remain open to interpretation. Dr. Seliger questions her profession and her past by allowing thoughts and feelings to gush upon the pages. Grief engulfs herself and leaves her in a quagmire of uncertainty and despair. And as readers we can feel it though we’re helpless just as Dr. Seliger remains somewhat helpless. She must come to terms with it in her own time and through her own distinct process. That’s the beauty of Koppelman’s rather poetic, journal-style writing. At times passages read as an open letter to Seliger’s dead brother. In order to understand herself she must splinter both her heart and her orderly thought process. Dr. Seliger must no longer resist what’s been holding her back from living freely with a level of contentment. That’s the trickiness with mental illness. It’s an up and down process for those who suffer with it and those who love those who live with it daily. This short novel packs a strong punch with lovely turns of phrase. Just like mental illness clear-cut solutions and fairytale endings do not exist. Managing the moment does. The mind remains a malleable work-in-progress. Koppelman writes with heartbreaking authority on the topic. It’s quietly effective, nuanced and moving.
Sarah Silverman earned a SAG nomination for her portrayal in the film adaptation for Koppelman’s second novel I Smile Back released this fall. I highly recommend the film. Silverman brilliantly depicts a woman struggling with her mental illness while raising her two children. One minute she’s packing school lunches, the next she’s snorting cocaine or crying on the floor. Honest and intense, it’s a must-see
published Here: http://entertainmentrealm.com/2015/12...
In Hesitation Wounds, a psychiatrist specializes in treatment-resistant depression. Sometimes meds just don’t work. When you’ve tried seemingly every medication and treatment plan with zero symptomatic relief, what can you do? You face despair and uncertainty. Dr. Susanna Seliger becomes the last resort for many troubled people. Of her practice: “When the MAOIs, TCAs, TeCAs, SNRIs, and SSRIs fail to get results, the patients are sent to me. And I zap ‘em. Or that’s what the movies would have you think. Electroconvulsive therapy (ECT), or, as it’s better known, shock treatment, is only shocking in that it doesn’t actually cause much, if any, physical pain. A patient’s emotional pain is an entirely different story.”
She makes every effort to avoid emotional attachment or involvement in how her patients feel but instead treats their symptoms. She maintains a professional detachment. She’s not there to talk and empathize. Dr. Seliger’s brother died and she feels quite a bit of guilt that she couldn’t save him. Koppelman elaborates: “You eternally seventeen. I try to figure out still. What I missed. Words I let pass, smells I didn’t recognize, unfamiliar tastes and sounds. Each an opportunity I failed to seize. Each a possibility to save you. Although now, so many years, so many patients later, I am aware that treatment is not without consequence, death without promise, visions without meaning. And handholding is merely that.” She now tries to save others from suicide. When a patient she allowed to break the emotional barrier [maybe he reminded her of her brother] commits suicide it throws Dr. Seliger into a spiral where she contemplates the relationship with her mentally ill brother and any warning signs she missed. Could she have stopped him?
“You can’t possibly know this because depression is an insidious disease. Robbing you of forethought, it makes you a reactive participant. Witnessing the world through the distorted prism of carnival glass leaves you feeling betrayed. The cruel nature of beauty. The unremitting groan of loss. You close your eyes and see him, cover your ears and hear. But that doesn’t excuse your actions. You should have said goodbye, Dan. Or at the very least let me know you had to go.”
Mental illness and its aftermath aren’t blatantly glamorized on these pages. The words remain open to interpretation. Dr. Seliger questions her profession and her past by allowing thoughts and feelings to gush upon the pages. Grief engulfs herself and leaves her in a quagmire of uncertainty and despair. And as readers we can feel it though we’re helpless just as Dr. Seliger remains somewhat helpless. She must come to terms with it in her own time and through her own distinct process. That’s the beauty of Koppelman’s rather poetic, journal-style writing. At times passages read as an open letter to Seliger’s dead brother. In order to understand herself she must splinter both her heart and her orderly thought process. Dr. Seliger must no longer resist what’s been holding her back from living freely with a level of contentment. That’s the trickiness with mental illness. It’s an up and down process for those who suffer with it and those who love those who live with it daily. This short novel packs a strong punch with lovely turns of phrase. Just like mental illness clear-cut solutions and fairytale endings do not exist. Managing the moment does. The mind remains a malleable work-in-progress. Koppelman writes with heartbreaking authority on the topic. It’s quietly effective, nuanced and moving.
Sarah Silverman earned a SAG nomination for her portrayal in the film adaptation for Koppelman’s second novel I Smile Back released this fall. I highly recommend the film. Silverman brilliantly depicts a woman struggling with her mental illness while raising her two children. One minute she’s packing school lunches, the next she’s snorting cocaine or crying on the floor. Honest and intense, it’s a must-see
published Here: http://entertainmentrealm.com/2015/12...
February 22, 2016
“Hesitation Wounds” is the story of Dr. Susanna Seliger who treats patients with severe depression by administering shock treatment therapy. For many years, she has shuffled through life by keeping herself closed off and ignoring her emotions which is why this work suits her. She doesn't believe in talk therapy and doesn't want her patients to confide in her. She just wants to buzz their feelings out of them. But everything changes when she treats Jim for whom the shock treatments don't seem to work. Talking to Jim takes her out of her shell and, in turn, forces her to face her grief over her brother, Daniel, who died when she and Daniel were both teens. “Hesitation Wounds” is mostly a dialog between Suze and her late brother. Many times, it reads like a letter to him. Throughout the book, Suze recounts moments from their life together. Many memories are pleasant. She recalls the summer when they hung outdoors with their friends, listening to the boom box, lying down and staring into the black city sky:
“It's the end of summer now. We are on our backs, arms and legs touching. We gaze at the moon. Margo thinks the moon is hanging especially low. It wants to shake your hand.”
But other times, the details of his tragic and somewhat reckless death creep through.
Her patient, Jim reminds her of Daniel. They both have similar builds and voices. Speaking of Jim elicits constant thoughts of death in her because he is suicidal. Just before he is about to receive another round of electric shock treatments which he has no faith will work, he asks her to tell him a story about what his life will be like six years from now. Koppelman's account through Suze of what a day in the life of a future, happily-adjusted, family man, Jim, will be like is beautiful and cinematic. It truly moved me, and I hope there will be a film version of “Hesitation Wounds” someday to see this passage unfold in pictures.
While most books depict grief by showing the event, having the mourner cry it out, completely traumatized, then describe them on the pathway to healing, Koppleman's portrayal of the grief experience is not like this. Grieving is not interpreted as overblown and dramatic. It is simple and matter of fact. But it's the facts that people have the most trouble facing. Grief does not get better over time but rather you learn to function better. As Koppelman explains, every day you are reminded of the person you lost through the mundane things around you. She asks: “What would Dan think of cell phones?” This sentence hit home for me because my father died in 1984, and with every new technology that comes out, I'm reminded of him: “What would Dad think of laptops? Social media? The internet?” This is truly what grief is all about: Your thoughts on a daily basis. In Koppelman's stream-of-consciousness dialog to Daniel, she writes:
“Things I forgot to ask: I forgot to ask you why you didn't like egg in your fried rice...how it was we began eating potato chips with ketchup, who your favorite Beatle was...”
“Hesitation Wounds” reminds us that life is about the little things. Besides grief, it is about depression and the simpler things most of us take for granted but can cause a person suffering from depression to get completely bogged down by. Every movement, interaction and inner thought becomes a feat of near impossibility, leading to exhaustion. Suze's depression is primarily caused by many years of unresolved grief. Here is how Suze has learned to survive her crippling thoughts of grief:
“I turn away. Memory is like this for me now. I can turn away from it. I repeat this thought out loud, as if the mere act of saying it, like an incantation, will transform the idea into reality. And because it's true. I can do this now.”
She stops and adds:
“Most of the time.”
Because that's how you move forward from grief. You just choose to forget. You don't heal completely, but you learn to live.
“It's the end of summer now. We are on our backs, arms and legs touching. We gaze at the moon. Margo thinks the moon is hanging especially low. It wants to shake your hand.”
But other times, the details of his tragic and somewhat reckless death creep through.
Her patient, Jim reminds her of Daniel. They both have similar builds and voices. Speaking of Jim elicits constant thoughts of death in her because he is suicidal. Just before he is about to receive another round of electric shock treatments which he has no faith will work, he asks her to tell him a story about what his life will be like six years from now. Koppelman's account through Suze of what a day in the life of a future, happily-adjusted, family man, Jim, will be like is beautiful and cinematic. It truly moved me, and I hope there will be a film version of “Hesitation Wounds” someday to see this passage unfold in pictures.
While most books depict grief by showing the event, having the mourner cry it out, completely traumatized, then describe them on the pathway to healing, Koppleman's portrayal of the grief experience is not like this. Grieving is not interpreted as overblown and dramatic. It is simple and matter of fact. But it's the facts that people have the most trouble facing. Grief does not get better over time but rather you learn to function better. As Koppelman explains, every day you are reminded of the person you lost through the mundane things around you. She asks: “What would Dan think of cell phones?” This sentence hit home for me because my father died in 1984, and with every new technology that comes out, I'm reminded of him: “What would Dad think of laptops? Social media? The internet?” This is truly what grief is all about: Your thoughts on a daily basis. In Koppelman's stream-of-consciousness dialog to Daniel, she writes:
“Things I forgot to ask: I forgot to ask you why you didn't like egg in your fried rice...how it was we began eating potato chips with ketchup, who your favorite Beatle was...”
“Hesitation Wounds” reminds us that life is about the little things. Besides grief, it is about depression and the simpler things most of us take for granted but can cause a person suffering from depression to get completely bogged down by. Every movement, interaction and inner thought becomes a feat of near impossibility, leading to exhaustion. Suze's depression is primarily caused by many years of unresolved grief. Here is how Suze has learned to survive her crippling thoughts of grief:
“I turn away. Memory is like this for me now. I can turn away from it. I repeat this thought out loud, as if the mere act of saying it, like an incantation, will transform the idea into reality. And because it's true. I can do this now.”
She stops and adds:
“Most of the time.”
Because that's how you move forward from grief. You just choose to forget. You don't heal completely, but you learn to live.
April 20, 2017
(Review originally posted on bookmyopia.wordpress.com)
How does it feel to be constantly burdened with grief, loss and guilt? When familial ties are not unfettered by your choice but all the “what ifs” are always going to haunt you?
In Hesitation Wounds, Amy Koppelman provides a searing glimpse into just what it is to live with clinical depression. To finally give up on life because of the inability to feel happiness. And what about the people who they leave behind, left to wonder whether they did all that they could to help? Whether they could have done more? Why didn’t they notice the signs that something just wasn’t right? Ask Dr. Susanna Seliger, who has grappled with these questions for nearly thirty years. Her profession, as a psychiatrist specializing in treatment resistant depression is both her penance and salvation. Her encounter and conversations with Jim, her patient, forces her to face what has been the albatross in the cesspool of her life, and has practically repelled anything that could have constituted a semblance of normalcy and fulfillment.
The book’s 180- page length is pretty misleading. Literally every paragraph is so beautifully constructed that it forces you to pause, re-read and think. It is a second person narrative by Susanna, each thought screaming out as a silent lament and a melancholic plea. To understand and be understood in return. To forgive and be forgiven. There is something so unflinching and no-holds-barred in the way Koppelman has shown us how it feels to go through so many emotions where you mind and heart is always a gooey mess because of the baggage of all the past that you cannot shed, and that in turn keeps nipping away at your present thus preventing you from creating and experiencing any new, happy memories worth recollecting in the future. So it is a disturbing, vicious cycle. And to be honest, around 50 pages into the book, I wondered whether it is going to be worth it sticking with Susanna till the last page. Because I have had reading experiences in the past where I felt short-changed in the end because the protagonists showed no growth or initiative to effect change.
Thankfully, Hesitation Wounds is worth it. The arc of the whole emotional narrative comes together in the final pages. And I love seeing things come to a full circle! (Without revealing much, I will just say that the book sort of starts and ends with Susanna in the airport). As the reels from Susanna’s past memories roll towards the final images, she lets it go. But will the happiness she finds make up for the three lost decades? Well, when I took leave of her in the last page, she seemed atleast in my opinion, the happiest version of herself after a very long time. So, maybe there is hope.
If there is one thing I felt could have been better, it is the clarity in the timelines. Susanna’s reminiscences keep going back and forth in a way that felt too jerky and vague. I am guessing it was deliberate to an extent, to probably show how recollections can be jumpy, colored and all over the place, but it just got a bit frustrating to keep track of it sometimes. And while I loved all the metaphors, symbolism and “quotable quotes”, it felt a bit excessive making the book a laborious read at times.
Keeping these quibbles aside, I would definitely recommend the book for a stark insight into what clinical depression is all about. It is a monumental labor of love by Amy Koppelman, a tribute to a cause she feels so strongly about.
How does it feel to be constantly burdened with grief, loss and guilt? When familial ties are not unfettered by your choice but all the “what ifs” are always going to haunt you?
In Hesitation Wounds, Amy Koppelman provides a searing glimpse into just what it is to live with clinical depression. To finally give up on life because of the inability to feel happiness. And what about the people who they leave behind, left to wonder whether they did all that they could to help? Whether they could have done more? Why didn’t they notice the signs that something just wasn’t right? Ask Dr. Susanna Seliger, who has grappled with these questions for nearly thirty years. Her profession, as a psychiatrist specializing in treatment resistant depression is both her penance and salvation. Her encounter and conversations with Jim, her patient, forces her to face what has been the albatross in the cesspool of her life, and has practically repelled anything that could have constituted a semblance of normalcy and fulfillment.
The book’s 180- page length is pretty misleading. Literally every paragraph is so beautifully constructed that it forces you to pause, re-read and think. It is a second person narrative by Susanna, each thought screaming out as a silent lament and a melancholic plea. To understand and be understood in return. To forgive and be forgiven. There is something so unflinching and no-holds-barred in the way Koppelman has shown us how it feels to go through so many emotions where you mind and heart is always a gooey mess because of the baggage of all the past that you cannot shed, and that in turn keeps nipping away at your present thus preventing you from creating and experiencing any new, happy memories worth recollecting in the future. So it is a disturbing, vicious cycle. And to be honest, around 50 pages into the book, I wondered whether it is going to be worth it sticking with Susanna till the last page. Because I have had reading experiences in the past where I felt short-changed in the end because the protagonists showed no growth or initiative to effect change.
Thankfully, Hesitation Wounds is worth it. The arc of the whole emotional narrative comes together in the final pages. And I love seeing things come to a full circle! (Without revealing much, I will just say that the book sort of starts and ends with Susanna in the airport). As the reels from Susanna’s past memories roll towards the final images, she lets it go. But will the happiness she finds make up for the three lost decades? Well, when I took leave of her in the last page, she seemed atleast in my opinion, the happiest version of herself after a very long time. So, maybe there is hope.
If there is one thing I felt could have been better, it is the clarity in the timelines. Susanna’s reminiscences keep going back and forth in a way that felt too jerky and vague. I am guessing it was deliberate to an extent, to probably show how recollections can be jumpy, colored and all over the place, but it just got a bit frustrating to keep track of it sometimes. And while I loved all the metaphors, symbolism and “quotable quotes”, it felt a bit excessive making the book a laborious read at times.
Keeping these quibbles aside, I would definitely recommend the book for a stark insight into what clinical depression is all about. It is a monumental labor of love by Amy Koppelman, a tribute to a cause she feels so strongly about.
January 20, 2016
For me, this is a book about things not being what they seem.
Memories can be mirages. Keepsakes can have no meaning.
An orange is a sphere. An elephant is a lesson, but which one?
Reality is only what we think it is. Beliefs can't always be known and are likely never understood.
We think we know the patient who is that man wearing a gown and shuffling his feet as he walks down the hospital corridor. Cancer? Heart? What about head?
Things are not what they seem quotes
Even our narrator, a smart and successful doctor, is not who she seems. It was interesting how my perception of her changed the more she exposed herself.
At one point towards the end of the book, I wanted to tell her that she should give people more credit for their resiliency. Not everyone is you, and not everything is about you. For folks who have read the book:
I appreciated the fluidity of the text, but the chronology was sometimes lost in the flow.
I think because of that, I began to challenge the set up. It's not giving anything away to say that our narrator is speaking to her brother. I believe that conversation begins when she encounters a patient Jim. Because the chronology wasn't always clear, I found myself asking questions like: "If you've been talking to your brother during this time, then you would have already told him about x while it was happening and not now in flashback." Koppelman is obviously talented, and I assume she has good editors, so the confusion is likely on my part. I suppose I wish there would not have been room for that confusion. I imagine that she had a timeline visible from her writing area, and I feel I needed one too.
My favorite quotes
December 23, 2015
I was given a copy of this book in exchange for an honest review.
This book is beautifully written and intensely sad. Not surprising, considering it’s a story about a doctor who works with treatment-resistant depression and ECT, but Hesitation Wounds is more about the emptiness inside the doctor than the sadness of her patients.
The first person perspective plus her writing style made me feel like I was reading a very long series of blog posts. This is not to say it was a bad thing, just that it felt less like a story than a confessional. I found myself wondering if there were parts that weren’t strictly fictional, because it felt so deep and personal.
At first I thought we would be spending more time with Jim, the young man introduced early in the story as one of Susa's patients. He seemed to be very important to her and I was certain that he was going to be the thing that helped her resolve her own lingering guilt and depression, so I was a little surprised things went the way they did.
Her history with her family unfolded slowly, with only hints of the incident with her brother given that sent me off into a completely different direction than what actually happened. It was satisfying because it gave me time to get comfortable with the characters and feel for them before I fully knew their stories. It also made certain aspects of her youth more heartbreaking, especially where her brother’s friend Ray is concerned.
The second half of the book felt more hopeful, and I felt my spirits lift with hers when Susa met her daughter and said goodbye to her cheating ex. It wasn’t long before the heaviness of the first half crept back in, but it couldn’t cover the happiness she felt when she talked about her little girl. The ending continued on in this way and brought tears to my eyes, seeing her come full circle as she did.
I really enjoyed this book on a lot of levels, but I do have to warn people that the subject matter might be a trigger for someone with depression or anxiety, and there are frank discussions of suicide. It’s not an easy book to read at times but I’m glad I have it in my collection. There are times you just want something a little deeper, and Hesitation Wounds delivers with a punch.
This book is beautifully written and intensely sad. Not surprising, considering it’s a story about a doctor who works with treatment-resistant depression and ECT, but Hesitation Wounds is more about the emptiness inside the doctor than the sadness of her patients.
The first person perspective plus her writing style made me feel like I was reading a very long series of blog posts. This is not to say it was a bad thing, just that it felt less like a story than a confessional. I found myself wondering if there were parts that weren’t strictly fictional, because it felt so deep and personal.
At first I thought we would be spending more time with Jim, the young man introduced early in the story as one of Susa's patients. He seemed to be very important to her and I was certain that he was going to be the thing that helped her resolve her own lingering guilt and depression, so I was a little surprised things went the way they did.
Her history with her family unfolded slowly, with only hints of the incident with her brother given that sent me off into a completely different direction than what actually happened. It was satisfying because it gave me time to get comfortable with the characters and feel for them before I fully knew their stories. It also made certain aspects of her youth more heartbreaking, especially where her brother’s friend Ray is concerned.
The second half of the book felt more hopeful, and I felt my spirits lift with hers when Susa met her daughter and said goodbye to her cheating ex. It wasn’t long before the heaviness of the first half crept back in, but it couldn’t cover the happiness she felt when she talked about her little girl. The ending continued on in this way and brought tears to my eyes, seeing her come full circle as she did.
I really enjoyed this book on a lot of levels, but I do have to warn people that the subject matter might be a trigger for someone with depression or anxiety, and there are frank discussions of suicide. It’s not an easy book to read at times but I’m glad I have it in my collection. There are times you just want something a little deeper, and Hesitation Wounds delivers with a punch.
December 24, 2015
I didn’t know what to expect from this book at all .. I have never had the opportunity to read any of Amy’s other books or indeed had any inclination as to what her style of writing was going to be like.
There are many subjects which should be ‘difficult’ to read or deal with but it is written in a such a beautifully haunting poetic way that it draws you in & enters your consciousness without realising the power it is having. I read it in two sittings but I think it is the after effect which will stay with me as I try to process exactly what she said or delve into my own thought processes.
How we deal with mental illness, death, suicide on an individual level is one thing but to read somebody else’s thoughts is a privilege .. it was comparable to a diary in places. I don’t want to hint at any of the characters because you will get the full benefit by reading it .. needless to say I really enjoyed this, felt in tune with the content & came away with hope.
Thanks to Amy for gifting me the book in exchange for an honest opinion .. I will seek out the others now & read those. Also thanks to Aimee @HelloChickLit ‘I Love All The Books Tours’ for the heads up :)
There are many subjects which should be ‘difficult’ to read or deal with but it is written in a such a beautifully haunting poetic way that it draws you in & enters your consciousness without realising the power it is having. I read it in two sittings but I think it is the after effect which will stay with me as I try to process exactly what she said or delve into my own thought processes.
How we deal with mental illness, death, suicide on an individual level is one thing but to read somebody else’s thoughts is a privilege .. it was comparable to a diary in places. I don’t want to hint at any of the characters because you will get the full benefit by reading it .. needless to say I really enjoyed this, felt in tune with the content & came away with hope.
Thanks to Amy for gifting me the book in exchange for an honest opinion .. I will seek out the others now & read those. Also thanks to Aimee @HelloChickLit ‘I Love All The Books Tours’ for the heads up :)
December 10, 2015
Dr. Susanna "Susa" Seliger is a highly respected psychiatrist who takes on some of the most difficult cases. But what most people don’t know is Susa still struggles with the death of her brother. While working with one patient, Jim, the memories of Daniel’s tragic death are brought back to Susa and she knows it’s time to sort them out.
Susa has learned over the years that the people she loves always leave, either by death or the end of a relationship. She also struggles with the feeling that something is missing in her life. When she finally realizes what is missing, the pieces start coming together.
This book is a roller coaster of emotions. My heart went out to Susa and all she had endured during her life. She works hard trying to help other people while her own memories haunt her. The story felt very true to life. At first I didn't know what to make of the writing style as it is different from what I am used to, but I caught on quickly. This book is incredibly thought provoking and will stay with you for a long time.
Susa has learned over the years that the people she loves always leave, either by death or the end of a relationship. She also struggles with the feeling that something is missing in her life. When she finally realizes what is missing, the pieces start coming together.
This book is a roller coaster of emotions. My heart went out to Susa and all she had endured during her life. She works hard trying to help other people while her own memories haunt her. The story felt very true to life. At first I didn't know what to make of the writing style as it is different from what I am used to, but I caught on quickly. This book is incredibly thought provoking and will stay with you for a long time.
January 22, 2016
I received this book via a giveaway on goodreads.com. It is a very short, but powerful book, examining the open wounds the death of a loved one can create; especially a loved one that was part best friend, part big brother.
This book takes a look at how a life can be ripped apart by death, especially a violent death. It shows that people who suffer such a loss often times look at a means to save others when they could not save their own, as is the case with Dr. Susanna Seliger, psychiatrist. When Sr. Seliger realizes that she once again lost someone she felt she should have been able to save, she looks over her life since her brother’s death over two decades previously.
This is a heart wrenching look at depression, and how the mind does everything possible to make itself whole again.
This book takes a look at how a life can be ripped apart by death, especially a violent death. It shows that people who suffer such a loss often times look at a means to save others when they could not save their own, as is the case with Dr. Susanna Seliger, psychiatrist. When Sr. Seliger realizes that she once again lost someone she felt she should have been able to save, she looks over her life since her brother’s death over two decades previously.
This is a heart wrenching look at depression, and how the mind does everything possible to make itself whole again.
December 24, 2015
Koppelman has had quite a year, not only with this insightful, poetic novel hitting the best "under the radar" novels of 2015, but also the Golden Globe nomination of Sarah Silverman playing the role that Koppelman wrote in the script based on her previous book, I Smile Back. And well deserved. It's hard to see the bones in this one because the poetry is so thick, the action so dense with sweet memories that propel the mystery of this sister and brother forward, the narrator's grief so compelling and real. This story is quite simple, yet the impact is profound - about love and life, the moments that make us.
December 4, 2022
I really enjoy Amy Koppleman lyrical way of writing, how she immerses us in the narrator's life and we experience it and feel it, rather than being spoon-fed information or told about it. After reading a Mouthful of Air, I decided to try this one. No disappointment here. Koppelman creates a complex narrator with a history that slowly builds, unfolds, and takes the entire book to fully reveal and understand.
January 7, 2016
I work in the healthcare field so this book was interesting to me. I have read a lot about depression and ECT but no much on treatment-resistant part. So this book kept me reading more. This book was sad but I still liked reading it. This story is written very well. * I received this book from the author in exchange for an honest review*
December 23, 2015
Amy Koppleman has done it again! I absolutely love all of her books. Each one has a deep message to convey to the reader and this one is no different. Definitely a very good read.
December 30, 2015
Truly beautiful novel about the legacies of loss and regret. Another one to add to my pile of excellent, quiet reads of 2015.
February 18, 2016
I really enjoyed this book. Dr. Susanna Seliger is an expert in her field which extremely hard to treat depression. She protects herself by not sharing her own feelings. This is her defense from falling apart herself. But she opens herself to her client, Jim. She finally gives in and tells about her brother who she always wondered if she could have saved from his depression.
This book is so very easy for me to relate to. My whole family has had depression in one form or another and I have also lost my brother to it. Amy Koppleman know depression. She knows that there are times when other are talking about mundane things and you are wondering about things that you can’t talk about at least at that time. She knows the deep, deep wound that never quite heals, the anger, the grief and the feeling of being left, the memories that slide in and out of your life, most of all the pain.
I didn’t want to lay this book down. It is not a book that goes from the past to the present, instead it jumps around. But that is how our lives are. Something will trigger a memory and if we can will stay with it and either feel the joy or the pain.
I received this finished copy of Hesitation Wounds from the publisher as a win from FirstReads but that in no way influenced my thoughts or feelings in this review.
This book is so very easy for me to relate to. My whole family has had depression in one form or another and I have also lost my brother to it. Amy Koppleman know depression. She knows that there are times when other are talking about mundane things and you are wondering about things that you can’t talk about at least at that time. She knows the deep, deep wound that never quite heals, the anger, the grief and the feeling of being left, the memories that slide in and out of your life, most of all the pain.
I didn’t want to lay this book down. It is not a book that goes from the past to the present, instead it jumps around. But that is how our lives are. Something will trigger a memory and if we can will stay with it and either feel the joy or the pain.
I received this finished copy of Hesitation Wounds from the publisher as a win from FirstReads but that in no way influenced my thoughts or feelings in this review.
June 8, 2016
Hesitation Wounds is an unusual, and quite honestly difficult book to read. It follows the life of Dr. Susanna Selger, a psychiatrist, who looks after patients that are suffering from severe, and treatment-resistant, depression.
When Susa meets one of her patients, Jim, there seems to be some kind of connection between the two of them, which brings on Susa having flashbacks, especially of her older brother Dan, who committed suicide many years before.
The story is told in both the here and now, and in the past, as Susa deals with her everyday life and her patients in the present, and has many a conversation with her dead brother in the past.
Sometimes the two do seem to intertwine and I did have to look back over a few paragraphs to work out whether I was in the present, or in the past, but this didn’t take anything away from the book.
The story is an emotional one and requires your full attention, but Amy’s style of writing and her true to life knowledge of depression make the story authentic and a pleasure to read. You can tell that Amy has certainly done her research into the condition.
If you are looking for something a little out of your comfort zone, I would highly recommend ‘Hesitation Wounds’, just remember the tissues.
Reviewed by Stacey at www.whisperingstories.com
When Susa meets one of her patients, Jim, there seems to be some kind of connection between the two of them, which brings on Susa having flashbacks, especially of her older brother Dan, who committed suicide many years before.
The story is told in both the here and now, and in the past, as Susa deals with her everyday life and her patients in the present, and has many a conversation with her dead brother in the past.
Sometimes the two do seem to intertwine and I did have to look back over a few paragraphs to work out whether I was in the present, or in the past, but this didn’t take anything away from the book.
The story is an emotional one and requires your full attention, but Amy’s style of writing and her true to life knowledge of depression make the story authentic and a pleasure to read. You can tell that Amy has certainly done her research into the condition.
If you are looking for something a little out of your comfort zone, I would highly recommend ‘Hesitation Wounds’, just remember the tissues.
Reviewed by Stacey at www.whisperingstories.com
May 6, 2016
Dr. Susanna Seliger, takes readers through her accomplished life. She is a successful doctor with a complete life; yet, a deep sadness in her life. We share her memories as a young innocent little girl as she is writing to her brother, whom she loves more than anyone, even now, several years after his childhood death. Suze takes readers along an emotional journey; we go in and out of relationships, experience several more losses, and finally, celebrate the ultimate gift she gives herself, complete happiness. All I can say without spoiling it, it this story ends in the most unexpected way, yet it’s perfect.
This was an easy read. Unfortunately, I found it a bit wordy; several section and dialogs didn’t contribute to the story. With that said, I still enjoyed the book and feel it warrants a rating of 4 Boundless stars....Beth
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This was an easy read. Unfortunately, I found it a bit wordy; several section and dialogs didn’t contribute to the story. With that said, I still enjoyed the book and feel it warrants a rating of 4 Boundless stars....Beth
http://www.boundlessbookreviews.com
https://www.facebook.com/BBReviews
January 22, 2016
This novel.
I originally looked at this book as something that I would devour shortly, due to the fact that it was just shy of 200 pages, I thought, "No big deal, I'll conquer this in a day!"
That my friend, was not the case. The language and imagery was haunting... so haunting and raw and realistic that I found myself reading a couple lines and closing my eyes to feel the sinking of the words.
There is a lot of feeling contained in under 200 pages... about love, grief, dreams. I'd recommend this book to anyone. I've now added Amy Koppelman to the list of "Oh my God, I need to read all their stuff!"
(I received a copy in exchange for a review.)
I originally looked at this book as something that I would devour shortly, due to the fact that it was just shy of 200 pages, I thought, "No big deal, I'll conquer this in a day!"
That my friend, was not the case. The language and imagery was haunting... so haunting and raw and realistic that I found myself reading a couple lines and closing my eyes to feel the sinking of the words.
There is a lot of feeling contained in under 200 pages... about love, grief, dreams. I'd recommend this book to anyone. I've now added Amy Koppelman to the list of "Oh my God, I need to read all their stuff!"
(I received a copy in exchange for a review.)
January 11, 2016
Beautiful language and imagery in this novel about a psychiatrist who specializes in patients with treatment-resistant depression. The true story is in the flashbacks to the main character's past as the reader learns what happened to her beloved older brother and as she comes to terms with both her past and her present.
My only complaint: The novel could be confusing at time with random paragraphs or sentences seemingly thrown in where I could not tell what the author was talking about. That is my only complaint keeping the novel from 4 stars. Sometimes I felt like I was speed-reading through nonsensical paragraphs to get back to the story.
My only complaint: The novel could be confusing at time with random paragraphs or sentences seemingly thrown in where I could not tell what the author was talking about. That is my only complaint keeping the novel from 4 stars. Sometimes I felt like I was speed-reading through nonsensical paragraphs to get back to the story.
January 4, 2016
The opportunity to spend time in the head of someone who has experienced depression and loss may sound like an ominous invitation, perhaps one that's not for everyone. But there's a lot of wisdom that comes from being with someone as they work and live their way through those things. That's the trip Amy Koppelman will take you on - in a really elegant, simple, wonderfully New York in the 70's & 80's- centric way - if you choose to join her.
Notes:
Hesitation Wounds makes a wonderful companion piece to "City On Fire"
Notes:
Hesitation Wounds makes a wonderful companion piece to "City On Fire"
February 1, 2016
This powerful book is filled with vivid scenes, I was left with images that give me a sense of what the character experienced, and even months later those flashes are still with me. This author is one of my favs--each paragraph, sentence is so beautifully crafted, it's mesmerizing. Her female characters are so layered, the book is a journey--complex, sad, fascinating.
Read
October 16, 2015Glad to have received a complimentary ARC of this one.
April 2, 2018
My first novel by Koppelman (at fewer than 200 pages this is more a novella than a novel), and while I thought it was ok, I gave it three stars because there is no doubt she has talent as a writer. What I liked: she can weave a good story. There is, for instance, a moment when the lead character, a psychiatrist, is telling a story to her patient about what his life will be like in the future, and it is lovely, lovingly written, and believable. I thought everything Koppelman writes in the story about loss, about grief, especially when it is under the circumstances of suicide, was heartfelt, and felt true. The pain the protagonist feels is real, and at times breathtaking. It actually hurts to read this. And that brings me to what I disliked: a novel that is all about emotional, gut wrenching pain, I think, needs to have some levity once in a while, even if it is gallows humor. It needs something to lighten the toll on the reader, even if only sporadically. I also did not like how the mother's character was treated: she is seen as a nuisance, even after her son commits suicide (not a spoiler alert, you know from the beginning), and without once acknowledging HER pain, the story feels less authentic. Or more selfish, I'm not sure which. I also got the impression a few time while reading that Koppelman was more concerned with her writing appearing lyrical, poetic perhaps, and because of that, there is less focus on the story. And my final jeremiad is that it was infuriating how she kept going back and forth, past to present, with the same characters, without it making sense or being obvious that we had switched from the present to the past. It took away from the story. So overall, two and a half stars. I am unsure if I would read anything else by Koppelman, or if I can recommend this.
December 27, 2016
I loved the cyclical meditations on the fallibility of memory and its expression in the structure of the novel. The prose really is powerful. But, as I got towards the end and the circumstances of Daniel's death became clearer, I began to get uncomfortable with its association with Michael Stewart's death. This is the second book I've read this year where a white main character with latent mental illness becomes fixated on racial injustice. And this is okay, because it's a glaring injustice and the characters have every reason to be upset, but it becomes about white people in the end. Actually, now that I think about it, for both novels it was mainly the family that objected to the characters' concerns about injustice and implied that it was beyond the scope of regular white liberalism (because trying to be a hero is different than an inevitable horrible death at the hands of authority). These main characters are sympathetic enough, but the authors are using black struggle as a device for the presumably more universal white experience of growing up and reckoning with the world. Combined with the way , there's a lack of introspection that is clearly present in other areas of the novel, which is a shame because the rest of it really resonated with me.
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December 6, 2022I've loved her other books. This one I simply cannot get into. I'm on page 95 and keep asking myself when it will "get good." I think I need more dialog between characters? Pages and pages of first person thought is terribly cumbersome (and boring) to read.
July 30, 2018
Depressing book about depression. Surprise!
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