A Diagnosis is a lockdown body-horror novel about Agatha, a chronically sleepless, debt-ridden, politically guilty New York writer who receives a mysterious medical label and begins to transform. It wants to be a novel about illness, surveillance, housing, privilege, police power, insomnia, fertility, coupledom, friendship, chronic pain, internet diagnosis, pharmaceutical bureaucracy, and the end of ordinary time. Mostly, it is an over-intellectualized spiral of symptoms and discourse, in which every physical sensation is immediately converted into theory and every theory is made to sweat inside a body.
The novel opens with Agatha buying clothes she does not remember ordering. She is trapped in a near-future lockdown city after the vaguely defined “Christmas events,” when protests, state violence, public-safety panic, and emergency controls turned New York into a ringed, surveilled zone. People are confined in pods of four, curfews are enforced, the internet is firewalled, some phone calls are blocked, cops occupy corners, and delivery logistics replace civic life. Agatha’s pod is her boyfriend Marco and their friends Nathan and Emily, another couple. The four are educated, left-leaning, precarious but protected, self-aware enough to recognize their privilege, and not nearly interesting enough to stop talking about it.
Agatha is the narrator and the problem. She has severe insomnia, chronic bodily complaints, health anxiety, money trouble, a stalled career, and a profound need to flee the person who loves her. Marco is kind, competent, politically earnest, physically healthy, and maddeningly available. He cooks, cleans, reads revolutionary history, torrents podcasts through the firewall, and tries to imagine some form of collective resistance. Agatha mostly scrolls, shops, fails to work, resents his tenderness, and turns every failure of action into an essay about why action is impossible.
