Meghan O'Rourke has written the book I'd been wishing for years had already existed: a book about not just what it's like to live with chronic illness but also what autoimmune disease is, and what our health care systems need to do better to do right by patients. O'Rourke's writing is powerful, engaging and highly quotable, full of clear and vivid metaphors that should help make concepts more clear to those who haven't themselves suffered from autoimmune disease. Her own experiences with hard-to-diagnose conditions over many years helped shape her research directions, and she also weaves in literature and philosophy on illness to reveal profound truths.

My one issue with the book is that I had hoped by the promotional copy on the inside cover that the book would be more intersectional (it notes that "the populations most likely to be neglected by our institutions include women, the working class, and people of color."). O'Rourke does note in a few places that many other people are sicker than she was and that many others receive worse care than she did. She also mentions research that women of color are taken less seriously by medical professionals than white women, and research showing that systemic racism alone is a health burden. But she also talks about going into debt seeing various specialists and practitioners that weren't covered by insurance, eating specialized diets and taking expensive supplements, dropping work for long stretches while she was unable to function - and never takes the time to really ask what the years would've been like for someone without those options. Other patients she quotes are largely historical literary figures (e.g. John Donne, Susan Sontag, Alice James) or O'Rourke's personal friends. I think the book could've really been strengthened by integrating more intersectional perspectives throughout, and/or dedicating a chapter to interviewing people who are struggling with these conditions without the privilege O'Rourke had.