‘It’s Important to Know That People Live’: An Interview with Harriet Alida Lye

The author of Natural Killer on surviving cancer, parenthood, and the “sick girl novel” genre.

In the spring of 2002, Harriet Alida Lye came down with what she describes as “a bad cold that never properly went away.” A few visits to the doctor’s office turned into a trip to the emergency room turned into an extended stay in SickKids hospital as Harriet, then only fifteen, was diagnosed with a form of leukemia referred to as “natural killer.” It was a cancer with an average survival time of fifty-eight days, with no known survivors. 

I met Lye in 2015, when we were both volunteering at a story writing workshop for children. We followed each other on social media and saw each other at literary events, and I came to know her as a bright and pleasant person who wrote lovely essays on Paris  and was working on a novel about a honey farm. It became easy to project my own ideas onto her life, as it often is with people you casually know and genuinely admire.

Reading Natural Killer (McClelland & Stewart), Lye’s memoir of her illness, meant exploding open whatever preconceived notions I had unwittingly brought along with me. The book is many things: a horror story about being betrayed by one’s own body, a treatise on making sense of the senseless through art, a love [letter?] to the author’s relentlessly loving parents. It’s a collage, made up with excerpts from journals that Lye’s parents kept during the year she spent in the hospital, as well as medical records and her own diaries. ‘When things aren’t serious, people can take an indulgent, almost shameful pleasure in experiencing pain,’ she writes astutely, about packing a suitcase to go to the hospital for the first time. ‘When things are serious, there’s no time or room for the fabrication of feeling.’

The book is also a memoir of motherhood, as Lye’s teenage experiences are interspersed with an unplanned pregnancy at thirty; unplanned, mostly because she was told that her intense chemotherapy would leave her unable to conceive. Natural Killer is a book that will give those already familiar with Lye’s writing insight into the experiences that shaped how she moves through the world. It will give newcomers to her work the feeling that they’ve known her for years.

A note on the timeline: We had originally planned to conduct this interview in person when the book was first scheduled to come out in April 2020; these plans were delayed for reasons that are probably obvious. The book release was pushed to late December, and we spoke in early 2021 over Zoom. It wasn’t under the most ideal conditions; I had been temporarily living with family, and instead of my usual trusty recorder, I was using an app on my phone to record our conversation. An automatic iOS update rendered the app incompatible; all my recordings were lost, tears were shed, and I gave up hope of ever recovering the audio file until a recent iCloud miracle brought it back into my life. My deepest apologies to Lye for the delay, though I hope you will agree her insights are timeless.  

Anna Fitzpatrick: Your book was originally supposed to come out in April 2020, and it was pushed to December 29, 2021 because of COVID-19. What was it like spending most of last year on the verge of having a really vulnerable book about to come out?

Harriet Alida Lye: I think I kind of forgot that it hadn’t come out.  When I would remember that it was still coming out, I would think, “Oh, I do have some things still to look forward to.” I had hope that it would have a better life in being delayed. Even though the world is on fire, perhaps even more so now, I think in April people still had such little bandwidth, and the publishing industry was still figuring out how to pivot. I’m glad it didn’t come out into that world.  

It really did shift my year. I was thinking that it would come out in April and that I’d go on tours and go to festivals in the summer, and in the fall, we were going to put [my son] Arlo in day care and I could start working on a new book, but I just didn’t feel like I could have closure on Natural Killer until it really came out.  

Given the subject matter and how much the world changed in 2020, has that altered how you anticipated the book’s response? In that it’s a book about dealing with illness and experiencing a huge shift in the day-to-day sense of living.

Yeah. I feel like my time in the hospital—but also my time as a parent of a young child on maternity leave—prepared me for a radical shift in my day-to-day experience. And I think that now so many other people know what it’s like to have your daily routine and your daily life completely changed for reasons outside of your control, even if that’s not from their own personal reasons but rather imposed externally by the world. And so, I think that there might be a resonance for people with this inward-looking time of isolation. In the hospital, I was literally in isolation for so much of the time and paranoid about catching germs from people. I carried Purell everywhere and wouldn’t let people touch me. So, I think that there are echoes now that there wouldn’t have been before. 

In writing the book, you drew on the journals your parents kept, old documents, a forum that your cousin set up. But you also write about your attempts to fictionalize your experiences, and reference early versions of a novel. When did you decide to make the switch to nonfiction for this story?  

In the book, I write about how it was a friend of mine who was like, “Well, did you want to die?” Because the girl in the novel that I was writing dies. When my friend asked it like that, I was like, “No!” People would always ask things like, “Why did you make it so the character is fifteen and doesn’t have any crushes or boyfriends? That’s weird!” People would ask these questions that I didn’t feel like I could have an answer to unless I wrote the truth. It was a story that I circled for so long through fiction.

I think when we met, Anna, I had a deal for the fiction version of this book with a publishing house that had a big turnover. A bunch of contracts moved or got dropped and my editor dropped my book and I never got an explanation for why. It felt like this huge failure. I think I was twenty-five, and I felt like this book contract gave me an identity as a writer. I felt like I lost that identity when I lost the contract. I left my agent because he handled it so poorly.

I think that that process was actually very important to approaching this book and making it feel like a more nuanced memoir.

Your life experiences have also changed so much. It’s a memoir about illness, but also a memoir about motherhood, and these two ways that your body can feel like it belongs to something else.

Totally. Like, it’s not your own body. I feel weird about the word “memoir” because I think that most people think of the word memoir as like, my life story. Even though memoirs right now are so exploratory, exploding that concept and showing just how varied the form can be, I sometimes just tell people that it is nonfiction.

I tried to write it as nonfiction in sort of a short-form series kind of thing, and it always felt like it was too navel-gazing—or like it was just too much about me and too much about a sick teenager—and it just didn’t feel right. And even though my friends reading it were telling me that it was compelling and it really was much bigger than that, it wasn’t until I got pregnant that I really felt like it could be a story about something else.

As soon as I got pregnant, I had this fear of what would happen to my baby. I think that it gave me this understanding of what my parents would have felt like, and what parents in general feel like when their children are sick. Also, just the hope that I had with having my own baby, I think that it was a counterbalance to the book. It allowed light and the future to come into the narrative in a way that it wouldn’t have if it was just a chronological story of my illness.

Had you been reading memoirs about illness or motherhood?

No, actually. Even though this is obviously a book about illness, it doesn’t feel like a book about illness in my mind. I think the book that I read that most closely matches Natural Killer is On Immunity, by Eula Biss. The way that she talks about how her pregnancy changed her perspective on vaccinations, and the history of vaccinations, and conversations she had with other mothers about their hesitancy vaccinating their children. She dived into this mythological history and cultural history and geographic history and etymological history. There’s a medical aspect and a personal aspect. She’s not anti-vaxxer at all. She’s very pro-vaxxer. But she shows the journey in a way that I think would appeal to somebody who might be vaccine hesitant. The personal and medical aspects are braided together very well.

I hadn’t read a ton of memoirs when I started writing mine. I didn’t even really know that I could do it the way that I was doing it. Once I got the deal, and once I started writing my book, I read more and more memoirs and I realized just how different they could be. I really love Annie Ernaux, the French writer. She wrote a book called Happening, which was about her getting an abortion when abortions were still illegal in France. The whole book is about this one event, how it happened, and her feelings about it. If there’s no access to abortion, you have to be incredibly covert and discrete about who you talk to. So that was another book I liked that had a medical aspect to it without being about sickness.

You said something earlier about how pregnancy shaped your perspective of what your parents went through. The book ends with the birth of your son, and now you’re living with this little human at home with his own little personality outside of you. Has that further shaped your perspective?

I’m really glad that I wrote it when I did because I think for me, the fear was most heightened during pregnancy and immediately afterwards. It was that feeling of like, my body betrayed me when it got cancer. I was really afraid of my body betraying me with having the baby. That fear was very poignant and profound in those early times. For the first year, I had anxiety, but I think that’s normal for most first-time parents. I don’t know a single parent who doesn’t worry about their child, but the more Arlo grows up, the less I’m able to think about it. So I feel like I wouldn’t be able to access those fears now, because I just can’t let my mind go there.  Like almost every other parent I know, I go into his room when he’s sleeping and make sure that he’s breathing. I was thinking about that just this morning, how every parent I know does that. And I haven’t heard a single story of a child dying peacefully and inexplicably in their sleep. Yet children get sick or have accidents, and those are the things that are much more likely, but I feel like I can’t let myself think about that. If I do it just paralyzes me.

Had you revisited those forum posts and old journals from when you were sick in the intervening years before you started working on this book?

I’m sure I looked at the forum posts in the years afterwards, but it was fifteen years later that I started writing this book and by that time the website was so old that the servers that hosted it had long since dropped it. But my dad is the kind of very organized engineer who, of course, archived them. He had those for me to look at when I asked later, when I was starting to write the book. I hadn’t looked at any of my medical records because that was all in the hospital. I had looked at the journals in passing, and I would occasionally glance through them because in the years that I would go to my appointment for my checkups—first weekly, then monthly, bimonthly, then annual—my dad was always reminding me to bring the journals. It was just part of this routine. 

I actually found it very, very hard to read the journals from start to finish because there’s this feeling of a climax in them. There’s a very natural arc of, “Oh my God is she going to live or is she going to die?” Even though obviously I know that I lived, it was still really dark.

I could just sense the possibility that there would have been the entry being like, “Well, 4:03 a.m., Harriet died.” When I was reading the part in which I was in the ICU and getting sicker and sicker and the doctors didn’t know what the infection was or how to cure it, in both the journals and medical records, I think my doctors and nurses and parents were striving for a neutrality, like a factual record of the events that happened. But of course, there’s so much personality that comes through in my dad’s voice and my mom’s voice and the doctors’ notes and the nurses’ notes in there. The doctors’ notes were generally a lot more sterile than the nurses’ notes. I think the nurses have to write in a certain structure, like, “Received patient awake,” or “Received patient asleep with father at bedside.” There’s a formula to the way that they write them that naturally has a bit more emotion to it. The doctors’ notes are usually just numbers, or “biopsy plan for 12:40 tomorrow with imaging,” or whatever.

There were the moments when I was super, super sick, and I could just sense the emotion in the notes. When the fever broke, one of the doctors wrote “Fever Broke!!!” Three exclamation marks. I could just sense his relief and joy, and that was really moving.

Reading this book, as you said, obviously you survive. But even with the best possible outcome, that you’re in remission and that you have this beautiful family, you still went through this incredibly traumatic thing. Both that fear and the daily trauma of this experience really comes through the page.

I think adding the present-day narrative was, for me, about adding the element of what it’s like to have survived that. Rather than just focusing on living through it, the present-day narrative allows me to have these interjections of thinking, “How did this affect the rest of my life?” There was a definite before and after in my life, and I think that so many people have these kinds of events in their lives that mark a before and after, whatever that might be. For me, it was very much about what it was like to have lived fifteen years without having had cancer, and then living the rest of my life having had cancer. I think there’s so many ways in which that experience changes a person, and adding these thoughts throughout the book from a present-day self allows for these questions to echo throughout the book.  

A few years ago, when I was working at a children’s bookstore, I remember there being a wave of young adult novels coming out about illness, cancer specifically, written for the most part by people who hadn’t gone through that experience firsthand.

Like [The Fault in Our Stars author] John Green.

Exactly, and a lot of similar books that came after his success. You would have been outside that age demographic, but did you read any of those books?

I hadn’t, but obviously I heard all about them. The fiction book that I was writing that I talk about in the book, called Everything We Could, I had been working on it for such a long time. It got submitted right as The Fault in Our Stars came out, and a lot of editors were like, “ehhh, it’s a similar theme.” I was so frustrated, because I was like, “This is a different story!” you know? It’s a personal story. I think that making it nonfiction definitely helped make it different from that genre. The “sick girl novel” genre.  

If a book like Natural Killer had been around when you were fifteen, detailing someone’s experiences of having gone through this and surviving, how do you think you would have reacted to it?

Oh, I think it would have been so, so important. As I write about in the book, so many of my peers who were in the hospital died. You don’t see that many hopeful stories, and it was really hard for me and my parents to not know anyone who had survived. My illness was so rare and unique.

I didn’t write about this in the book because it’s about somebody very specific, but a young woman who actually went to the same university that I ended up going to, she had AML, which was one of the variants I had. She had a bone marrow transplant, which I was supposed to have. I can’t remember who it was that connected it—it might have been a social worker at SickKids—but she was treated at a hospital in Kingston. It was an adult hospital, so certain procedures were different. She wasn’t anesthetized for a lot of procedures that they anesthetize children for. Anyway, when I was in the middle of treatment, we were connected and she came to visit me a couple of times. And I remember, that was a huge light. For both my parents and for myself, the idea that she had gone through this and now she’s in university. She ended up getting her PhD and I think she’s a doctor now. It was just really important to know that people live.

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