Writers Hilary Plum and Caren Beilin live on the east side of Cleveland. Before, both lived in Philadelphia, where they met over a decade ago. Plum’s and Beilin’s novels, memoirs, and essays also read like neighbors, keeping in common a vivid clear-hearted humor and a commitment to finding forms to think and live and preserve each other now.
Both have new novels out: Plum’s State Champ (Bloomsbury) chronicles an ex-runner, ex-receptionist’s hunger strike after the abortion clinic she works at is shut down and its doctor is imprisoned. In Beilin’s Sea, Poison (New Directions), Cumin Baleen tries to write about medical malpractice in the wake of a mind-altering eye surgery. Plum and Beilin’s conversation about these novels, conducted in fall 2025, covers sincerity’s limits, unspeakable subjects, writing sick, discreditable narrators, and more.
Hilary Plum: Caren, I got to hear you read from Sea, Poison a few times over the years you were working on this manuscript. Whenever you read, you rightly introduce this novel as being “about gynecological crimes.” And then often, in these readings I’m remembering, you would read a passage that was extremely, devastatingly funny. Often this passage did not seem, on the surface, to be about gynecological crimes—a fact that was also potentially funny, but the joke of that felt dangerous, as if the joke was already pointing out to me how those crimes get covered over, unwitnessed . . . Now that I’ve read the novel in full, I am struck by how delicately and innovatively it is always talking about the loss inflicted by these crimes of misogyny—what’s taken; the loss that is the suffering—even or especially as the novel seems to be talking about something else (what other way to speak of loss), from medications treating autoimmunity to scam eye surgery to the films of Daniel Day-Lewis to bad Oulipo to absurd housing situations in Philly.
So a first question I want to ask is how you did this—like, the details of how. This book is in dialogue with Shusaku Endo’s The Sea and Poison, which unfortunately I have not read (mostly if someone mentions a book, I haven’t read it, though I swear I read all day every day). Endo’s novel is described as about the medical torture and vivisection of POWs during WWII, as narrated by a doctor who participated therein. Your book uses indirection to become direct, and uses humor to direct our forms of comprehension toward a crime that remains so hard to comprehend and to witness (and which, as your novel emphasizes, must be thought of as ongoing; the cases of its prosecution expose how long prominent offenders continued in their abuse before anything happened). How did you come into, or come upon, or learn to overcome the reader by this way of writing—writing both directly and indirectly, over and around and about the unspeakability of your subject, with dark humor lighting the way?
Caren Beilin: The first draft of this novel was a syntactical map of Endo’s The Sea and Poison. My version (of Endo’s book about human vivisection during World War II Japan) was based off of Javaid Perwaiz, an OB/GYN who practiced in Maryland—now in prison. He did a lot of things, including a lot of unneeded hysterectomies to cash in with insurance companies and Medicare. But I set it in Atlantic City, a place I grew up in, and grew up knowing was where a lot of people got screwed over by a criminal developer who never paid them.
I had to change it. It was missing voice. So I wrote a whole other novel with different stories in it, and a lot of jokes, more me, because I’m angry so I have to joke, and have fun. But this first thing was always behind it. Sometimes when the new people (or the protagonist, Cumin Baleen) spoke or noticed things, or had phone calls, it would be about this.
I mean, I wrote a novel about gynecological crime and you, about the breakdown of abortion access. We must have both felt quite seriously about all of this . . . yet we both wrote these highly comedic novels. And our protagonist-narrators are not exactly heroines of the cause. Did you think about issues of sincerity as you worked? Were you worried, as I was, about how to convey sincerity (or sincere problems) in such an insincere form (the novel)? Like, for me, one consideration was: who would even want to pick up a serious book (or a virtuous one) about this stuff for even one second?
HP: Over the summer I watched panels from the Gaza Tribunal, the session held in Sarajevo in May. I remember one panelist—I was jotting thoughts down and don’t have a proper citation—discussing the “post-truth” context in which the genocide is being perpetrated. My notes on their use of this phrase “post-truth” say: “not about media but speech/power—the offense that people espouse values, use a word, but mean nothing, aren’t held to any idea of its meaning.” I don’t know if this is my language or the panelist’s. Their discussion helpfully described something I too feel: the malice and nihilism of this public emptying of language, something beyond hypocrisy—“post-truth” as a metastatic stage beyond “truthiness,” that Bush-era Stephen Colbert term.
E.g., in the case of Perwaiz and others, I keep thinking about not just the horror of the crimes but the horror of the fact that nurses—professionals, but who are mostly women—did raise concerns about the abuse they suspected or witnessed, did speak out, and it didn’t matter. Eventually, too late for so many victimized patients and probably too late for these nurses’ sense of the profession, they were redeemed by these big public trials and convictions. The #MeToo movement exposed the layers of suffering caused by situations like this, in which people are speaking truthfully about crimes, harms, what are supposedly shared values, but their speech is dismissed because they don’t have enough power or capital to be listened to. Their truths are dismissed because they as people can be dismissed. #MeToo briefly seemed to create a possibility for language to matter, for women’s and others’ testimony to actually be meaningful and count. But then #MeToo was largely denied lasting effects. So the dismissal and silencing of its origins have been, I think, redoubled. The promise of the movement has vanished into a darkness that sometimes feels even darker than if the whole thing had never happened.
So your question: why humor? I guess I’m trying to describe some ways that sincerity fails and is failing. The road of sincerity has dead-ended, post-truth. Yet the road of testimony must somehow remain open, because we desperately need it. You have collected vital testimony—on gendered medical gaslighting, as experienced by yourself and others—in works of nonfiction/essay like Blackfishing the IUD. Implicit in projects like that is the question: who are we even fucking talking to?
We’re talking to each other. Even if we all feel powerless, can we talk powerfully? I love hearing about the palimpsest of two different novels converging into Sea, Poison, and that the aim of the second version was to sound like yourself. This isn’t always seen as a novelistic aim; novelists have big pretensions about representing or addressing something bigger. I wanted the voice of State Champ to sound like me, but a version of me I’d never gotten or managed to be, so I was freeing myself personally. I think the best way to write a novel is actually for yourself and a few friends because it’s hard to bullshit people that close for that long.
I don’t know anything about the context of Endo’s work. I wonder what conversation on this subject he was joining and if he was received as an authoritative, meaningful speaker (I hope so). I am not sure we have that option anymore, of imagining this public or thinking we could address them, even if it turns out that way. Sea, Poison feels like the work of a writer who is very very free in herself and making the case for her own thinking without justifying herself to anyone. It is so exhilarating to encounter the freedom of artworks like this. So my next question is: how do you think or not-think about a reading public, an audience, a community that a novel serves or incites, speaks to or for? Your novel is innovative in its approach. It won’t “be for everyone” but it may innovate a readership or a reader’s feeling. By being private it may be wildly public. How do you find yourself navigating these questions of audience, who a book is for, what its public role is, once it’s off the desk and out in the world?
CB: Endo published The Sea and Poison in 1957, so less than ten years after the Kyushu University trial in Japan, which would reveal some of the horrid details around the human vivisections. I read his novel as one of near-contemporary witness, and an extraordinary act, to be surveying these acts as a Japanese person. In The Sea and Poison, Endo does not depict individual actors as evil, but as those who are swept up into an industrialized, militarized medical system, whose purpose is ambition and thus, power. Power spreads through these powerless actors—it is mechanized.
In the cases I’m looking at here, there’s this mix of unconscionable people, Perwaiz, Nassar, Haddon at Columbia, Tyndall at USC, and then there’s the support staff, the universities, the FBI, the Olympic Committee, all these other people who aren’t really even people, they’re the mechanism. Not to absolve them, but in a way, I’d say, what they were doing was their jobs. Their jobs exactly.
I mean, fuck work.
With a shout-out, of course, to the whistleblowers, people like Dawn Wooten, a nurse who spoke out about Mahendra Amin, “uterus stealer” at the Georgia ICE facility. She was not doing her job.
I agree with you, speaking up feels hopeless/helpless. The #MeToo movement was such a temptation, like, would all the light come ripping into the room? Would I suddenly not be alone with the things that were being said and done, because all the light, the light of what, the light of the internet, of other people, even the media, would be there with me, perversely on my side? Oh I ran into that light. But it was basically the harsh light of punishment. Punishment ricochets, I guess. Maybe what we need more, in the long run at least, is the warming glow of awareness.
I think both of our books are glow books. Glowering, sure, too. To put that more on the ground, vis-à-vis Sea, Poison, it’s not a book that focuses on the criminal doctors, re-describing their crimes (like the first draft). It’s a book about a writer, Cumin Baleen, who’s becoming aware of these things that happen and are happening, is enveloped in a dawning, who is reading and writing and talking about this stuff, and also a lot else, and also wants to get off (so badly) and feel the sun. “To me, feeling hot is almost everything that’s out there.”
The doctors who did the human vivisections in Japan went free. Some of them were sentenced and imprisoned, and were supposed to be executed, but they were released by Truman in ’58, in a push to normalize US–Japan relations. Punishment is fickle, I guess. A glowing book though… chef’s kiss!
Readers of our books, in my estimation, will have to do some work around being good—good readers of good books. Where you’d find the point that was given to you by the good, engaged, helpful woman. But Endo was like this! His book is just wild. You can’t find a side, a person to run to, a right way of being. Or anything to do. All you end up doing is looking out at the sea. Endo might say, There’s so little to do. Not exactly an activism . . .
So let’s talk about that. Because your book is about this messy abortion-rights activist, who hasn’t prepared and isn’t someone to easily get behind. She makes a mess with unclear outcomes. According to certain Goodreads reviews, there’s even an accusation that your narrator’s history with anorexia makes it very messy indeed that she would now glorify going on a hunger strike. She’s, like, disqualified, because it turns out it’s pathological.
I don’t think we should speak back to Goodreads reviews, Goodreviewers or whatever, but can you say something about why it felt interesting to posit someone who’s sort of an easy target, easy to discredit?
HP: I extremely wanted Angela’s disability—if that is the word for it—her mal-ability, to be part of her work, her activism. (Angela is the protagonist of the novel.) She’s going on a hunger strike in protest for a good cause. Her boss has been imprisoned for providing abortions and she wants to protest that. Whether or not her hunger strike is a great idea, it’s her first idea in a while, and it’s about care, it’s an idea for others. But like you say: I wanted it to be connected to what was hard or dark or “diseased” or maybe “impure” in her history. That’s real and, I think, good.
You and I, e.g., are both people with chronic illnesses. I wish my life weren’t shaped by my chronic illness, but it is, and in ways I definitely don’t “like.” But I can’t do anything about that. I’ve written and thought about my illness and maybe that’s redemptive, or not always. Angela is using her old illness to do something new and maybe that’s redemptive, or not always. Her eating disorder really fucked up her life because it ended her running career. Like everyone, she doesn’t have any choice about her bad history. So why can’t she try to use it for something good? That was my hopeful and maybe dangerous question. But I think real hope involves risk.
To me this also relates to the specific nature of eating disorders. Because they involve food and either eating or not eating, in recovery you never really get to some pure place. You have to keep having a relationship with food, weight, eating, exercise, choice, body image, etc., all day every day in a fucked-up culture. You don’t have the clarity of, say, abstention from one substance (not that this is easier, just clearer). You have to get to a better place and try to stay there more than you slide back. So yeah, the relationship between her former anorexia and her current hunger strike isn’t totally clear, the categories aren’t pure. I think this disturbs some people because people like purity. I did expect that reaction.
I feel like I should add that I’m a recovered anorexic. And maybe that anorexia is hard to recover from. Last I researched, the statistics were roughly that twenty-some years out, about a third to half of people have recovered, a fifth to a third still struggle with symptoms, and a fifth to a third are dead. For a long time it was called the most lethal mental illness, but recently was displaced by opioid abuse. Oof.
I guess like Endo, like you, I feel wary of heroism or purity in fiction. I look for complicity, implication. I’m a noir fan. The detectives aren’t well. In life (and this is probably what I’m trying to correct) I have been seduced by myths of the good girl. Anorexia is often part of that too and it doesn’t work out well.
In this book I was trying something I hadn’t tried before. It relates to something I really want to ask you about. To honor Angela, I was trying to write in a “sicker” language. When my neurological symptoms are active, I don’t have a good relationship with language. I can’t read well, I can’t write well, the higher levels of the work are inaccessible. “Brain fog.” I have always had firm boundaries about my sick vs. my well activities. Writing is for the well me, the good me. When writing this novel, I thought: that’s wrong. I should borrow some of the sick me’s language or just let her in. Why am I keeping her out (I mean, partly that’s just practical—she feels bad, she’s lying down or hoping to lie down). So in small ways, as I tried to put some of my intellectualizing self, my good student self, to the side, and learn to think and speak more like Angela would, like someone in her situation would, I let myself write sicker. Broke down the boundary a little, let things get polluted. This may only have made a few small differences in language but it was a big change for me, in my mindset.
In your novel, our protagonist Cumin Baleen has had this messed-up eye surgery that has messed up her brain and particularly her relationship to language. For a while, she tells us, after the surgery, she stops writing. And then she can only write these “stuck, plain sentences”—she can’t “make a sentence with more than one clause,” so “a sentence no longer had any copulatory frenzy,” it’s lost its meaning-making hotness and possibility . . . For Caren Beilin, this would be hell. I have my own ideas about why this state of diminished, normalized, oppressively limited expression belongs in a book about gynecological crime (and I want to praise some sly connections you make to Oulipian practice, say, as a choice, versus Oulipian constraints as brutality in real life). Can you say more about how and why you put this condition—this potential loss of syntactical power, in fact the exact kind of syntactical power that is Beilinian—in this novel? What happened once this condition was part of the book?
CB: Thanks, Hilary. I like a story that is launched out of a condition. Some favorites include Trouble Every Day, Butler’s short story “The Evening, the Morning, and the Night,” and Sartre’s Nausea.
So yes, Sea, Poison begins with the problem of a catastrophic eye surgery that has created this effect where Cumin can only write in a spare way. You are right this is my nightmare, so that’s one place to start, that sometimes that’s a way to write, to write out your nightmare. I also found it to be a handy figure for writer’s block. And I suppose there’s some frustration in there, about my relationship with some editors, or readers (I say to one of my editors . . .), where I have felt appalled—or rather, it’s my relationship to corporate fiction in America, which is so anti-intellectual, and whatever, I’m sick of people calling perfectly stylized sentences “run-on” because they are long.
I mean, basically my whole life as a student of creative writing, a creative writer with editors and readers and reviewers, my whole time is massively characterized by people telling me I should shorten my sentences, write more simply, be less extravagant, be clearer, dumber and muter. So.
(I’ll say here that in each and every case of my books, this is not true—all of my books without exception have been published by miracle editors) (you are one of them).
It’s part of the design that certain people will be interrupted. I don’t like being interrupted on the level of the sentence, which is a special place and thing that you can make wide and strange and that could accommodate wellness and sickness, that’s one thing clauses could help out with.
Interesting to think about the sick self interrupting the well self—but wellness, also, is something that interrupts sickness. Or I don’t know, I like to think about the times I’ve been sick (or for me, maybe I think of it more in terms of pain) and then being well interrupts it. So I guess sometimes interruption feels like mercy! I’ll keep that in mind . . .
Maybe I’ll ask you one more? With Angela, she’s not a “good” activist for abortion rights. Her outcomes are dubious, of course, and the book doesn’t end with abortion access being restored in Ohio. What a failure! In a neat double, you, Plum, wrote an incendiary novel about abortion access and, it turns out, that also didn’t restore the access. Fuck!! And I wrote a book about gynecological crime that I doubt will further penalize bad actors in the medical system or, like, help warn everybody about what? The potential for harm in medicine. I don’t know what a warning will do . . .
Do you have any thoughts around why to write about “issues”?
HP: I think it has to do with an idea I like to keep close (and a grateful nod to the writer Peter Dimock): that literature is an alternative present. Not an alternative history, not a possible future, but an alternative present you practice now. When I started State Champ, Roe was still Roe, and abortion access was fine in Ohio—a heartbeat law had passed on the state level that was, of course, blocked because of federal law. Then Roe fell, chaos and restriction reigned, and then the people of Ohio organized and held a referendum and enshrined abortion rights constitutionally here. So that’s good. And of course Ohio’s right-wing (which controls all three branches of state government) is still trying, like every day, to flip things back and kill abortion again. And they’re using their successful strategies, their skills sharpened in anti-abortion activism and TRAP laws, etc., to harm and kill so many other things.
So the role of the novel is to keep practicing. If abortion’s legal now, you practice for the dark days. If it’s illegal now, you practice the good work, you try to call up new forms for the work. You are sharpening your skills and those skills serve imagination, privacy, how we know one another, how we connect, how we know history and possibility at once. The solitary and the communal. Your novel isn’t about something limited like cheerleading a guilty verdict for Perwaiz et al. Only a monster would need that reminder and those monsters aren’t reading your novel anyway (well, I hope they will, but probably not). One thing your novel is about: practicing for when this crime gets close to us. Another: practicing knowing how to see and do the things that are so discouraged it’s like they tried to burn what we knew and saw from our brains. Another: how to preserve—how to double-down on—our humor and horniness when they keep coming at our uteruses and brains.
I think we write about issues because they are the real constraints. They are so hard to imagine beyond, so that’s the work, that’s the responsibility. And I think novels have to help with the indirect stuff. The direct stuff needs direct institutions: guilty verdicts, safe housing, healthcare, universal basic income, etc. But we all need some fucking company and someone to recognize that we’ve had thoughts and feelings that have never even been said. That’s what a novel is medicine for. I sometimes have trouble believing in it myself but it doesn’t matter. Literature doesn’t need me personally to believe every day. It’s bigger than me.
Speaking of: what’s something new you’ve noticed or learned about your book, now that literature is receiving it, readers are talking to you about it?
CB: Oh, Hilary. It is great to keep talking to you in life. Company, keeping good company, of books and people and ways of being, moving, mattering—I mean, that’s nice. I keep thinking (because I’m talking with you) about this excellent clip of Sinéad being interviewed by Arsenio Hall in which he’s talking with her about all these controversies that follow her and she basically flips the whole interview into this session where they are both seriously hitting on each other. She’s calling Arsenio gorgeous and they’re making plans for a spanking session (amidst seriously decrying war and capitalism).
Right now (as we’re talking) Sea, Poison has been out less than a month. It feels a bit strange. I can’t tell what is happening. I’m reminding myself of something the poet Brian Teare once told me when I ran into him at Good Karma, in Philadelphia, that a book, once it’s out, becomes a stray cat and you don’t know where it’s been, what alleys, maybe it only curled up behind one dumpster, you don’t know. A friend recently told me that this technique for using eye drops that’s explained in the book seriously helped her figure out a better way to administer eye drops and I was, like, deliriously glad. The novelist loves to feel useful!
Close your eyes and then put the drops in the corners. Then open your eyes and they can slide right in. Voila.
My mom listened to the audiobook and she loved it, which made me very happy (because she’s in it). I’m glad I got to read it to her like that. I’ve given a few readings for it and felt really good when I could hear people cracking up. I lurked on an Instagram conversation where some people were wondering about their interests/thresholds around reading books that are emotional and where you might feel rage. A lot of people would like a lot of gentleness right now. Sometimes I fantasize that the right man will tell people to read it and then they will. I have fantasies a lot of times and in every area of my life that there is a right man who can solve my problems with the pure nectar of his signification—if he can go out ahead of me, with his good affect and effects, I could move into the threshold and make it shimmer with rage. But so far in all aspects of my life I have to ultimately, at least, exist as a complaint (that’s maybe hitting on you) and see who’s bored, interested or perverse or wayward or around enough to be with me a little, which gives me obscene honor.