The Invisible Kingdom: Reimagining Chronic Illness

O’Rourke’s memoir Invisible Kingdom: Reimagining Chronic Illness is published in 2022 as the world still reels from the global pandemic of COVID-19. As anyone who lived through this time will know, one of the main mysteries of COVID is the mechanism by which the virus impacts individuals in completely different ways. Some people contract COVID and feel like they have a cold, while others contract COVID and die. Then, there is the subset of people who contract COVID and go on to experience symptoms of long COVID. Society has had to confront the cultural and economic significance of dealing with huge numbers of people who have mysterious, unknowable symptoms that cannot be cured. The historical and social context of the COVID pandemic is essential for understanding how O’Rourke’s book might be received by readers in 2022, as opposed to those living in a pre-pandemic world. The pandemic brought words like “autoimmunity,” “chronic illness,” and “incurable disease” to the forefront of people’s consciousness, raising general awareness that many people have weaker immune systems, and the inherent invisibility of this vulnerability means that those with chronic illness and autoimmunity have had to advocate for their own protection in the presence of a rapidly spreading, barely understood virus. As a result of the pandemic, American society became aware of the ways in which a specific illness can impact certain social groups differently because of the structures of the American medical system. For example, those who were uninsured or socioeconomically insecure were in a much more vulnerable position than those who had ready access to medical care.

Additionally, COVID rendered visible the ways in which the “well” and “unwell” are interconnected. O’Rourke’s book seeks to illustrate the struggles of those with chronic illnesses for those who have never experienced it and to argue that the collective is responsible for providing a solution to the rise of autoimmune and other chronic illnesses. The global pandemic has impacted all of society and required the participation of many in order to protect the vulnerable, forcing a collective shift that requires society as a whole to prioritize the health and safety of those with illnesses instead of marginalizing them. Much of O’Rourke’s book criticizes the American medical system while offering solutions that might create meaningful care for patients like her. At a time when conventional care is being questioned globally, O’Rourke’s message advocating for systemic change in the American medical system has a tremendous impact. Toward the end of the book, O’Rourke even cites conventional medicine practitioners who radically reimagine care for those with long COVID. In this context, O’Rourke makes the case that all patients with chronic illness deserve the same high level of care.

O’Rourke imagines herself in The Invisible Kingdom as being part of a lineage of authors who write about illness. She advocates for storytelling as a means of more fully articulating her experience to herself and to others as well. In this endeavor, she creates a different type of storytelling—one that isn’t linear but is instead true to her own internal experience. Her narrative may be chaotic at times, even cyclical, but for an audience intimately familiar with the effects of COVID, this message is designed to provide both comfort and permission to express the invisible nuances of living with unexplained illness. O’Rourke displays her eventual acceptance of uncertainty and lack of clear narrative structure in order to encourage others to accept the validity of experiences that cannot be conveniently labeled or defined, for even unknowable experiences deserve to be known and acknowledged for the immutability of their own internal truths.