By Vyshali Manivannan
A choice-based interactive nonfiction game, Hollow Me, Hollow Me, Until Only You Remain plunges you into the simultaneously tedious and harrowing experience of entering New York University (NYU) Langone’s emergency room as a fibromyalgic nonwhite queer woman in crisis. You arrived here because you are in a state of emergency: something inside you is rotting; for nine months, doctors have dismissed it as a flare-up of your usual chronic pain and fatigue; your body’s defenses, buckling under this negligence, are finally breaking down.
As a chronically ill patient, you know all too well that your skin color, gender presentation, and non-apparent pain will impact the care you receive. Your only recourse is to aggressively engage with your medical records as various emergency physicians assess and reframe you in the patient intake process, crafting a patient identity for you that is sharply antithetical to what you are trying to convey.
Hollow Me, Hollow Me, Until Only You Remain was originally composed online for my digital dissertation. It is an autoethnographic inquiry into the violence perpetrated by curative logics, ableism, and medical paternalism. An interactive, immersive resource for writing studies, media studies, and disability studies classrooms, this “game” is a rhetorical analysis of the medical gaslighting, gender- and race-based stereotyping, and narrative imposition I endured during a weekend-long emergency room visit in September 2014, nine months after my appendix had perforated. As an Eelam Tamil woman living with chronic pain and fatigue since 2006, I present and interpret my pain in ways that don’t align with ocularcentric medical standards. I sought care from multiple specialists starting in January, but—due to my articulateness, my dress choices, my gender and model minority status—I was repeatedly told not to worry; “it’s probably a flare-up.” By September, I could barely eat, drink, or walk and felt constantly disoriented and relentlessly pursued by a sense of impending doom. Finally, a doctor ordered an emergency abdominal CT scan which revealed extensive inflammation (“Your pelvis looks like a bomb went off; how are you still standing?” the radiologist marveled), and I was sent to the emergency room at NYU Langone.
While this experience is detailed in full in my dissertation project, Hollow Me focuses on my medical records from that weekend to expose how self-reporting by chronically ill women of color is so quickly and easily undone by physicians who do not believe us, who insist that their expertise and authority over our bodies supersedes our own, who stereotype us, (re)traumatize us with unnecessary, painful procedures, and—most damningly—rewrite our patient records to reflect their specializations and beliefs, even if that means erasing previous diagnoses and associated regimens of care.
Texture Writer, the interactive fiction engine that powers Hollow Me, lets you drag verbs (Action Behaviors) from the bottom of the screen to hot spots in the main text, which modifies or replaces the highlighted text; appends new text to the hot spot or at the end of the page; or takes the player to a new page. In Hollow Me, players use Action Behaviors to engage with my medical records from my 2014 ER visit. Hot spots are designated around the inaccurate, biased additions and changes made by physicians without my knowledge or consent that imperiled my future health care and my life itself. Countless stories like mine—disabled BIPOC women whose descriptions of pain are doubted, dismissed, or reframed according to Euro-Western biomedical standards and gendered and racialized expectations—do end tragically, with loss of treatment or death. I got lucky: a surgeon believed me and overwrote the edits to my record. If he hadn’t, it’s likely I wouldn’t be here today.
Complicity plays a significant role in the emotional power of stories driven by player agency. Whether I intended it or not, disability justice is built into this game. In immersing players in this all-too-common experience, Hollow Me values the teachings of bodyminds like mine, centering the knowledge of those most impacted. It emphasizes the importance of intersectionality and affirms that the disabled patient’s identity is that of a whole person whose worth isn’t dependent on normativity or (re)productivity. And through many of its Action Behavior “consequences,” it asks that academic writers be mindful of the fact that scholarly writing about the body—devoid of embodied language as it is—can reify the absence of poetics in clinical practice, which in turn has material consequences for patients who rely on metaphor to describe the embodied experience of chronic pain. Especially disabled women with a decolonial framework for pain, whose pain is regularly considered suspect.
By envisioning this experience as an interactive nonfiction game, by making players complicit—in either accepting the clinicians’ version of events or making edits that reclaim my patient identity—Hollow Me requires players to examine their own preconceptions, challenge the oppressive logics and practices of medical spaces, and consider what self-advocacy, collaborative resistance, and collective liberation might look like.
The interactive fiction game can be played online here or by clicking on the image below.
A note on design
Hollow Me (CC BY-NC-SA 4.0) is powered by Texture Writer, an interactive fiction engine created by Juhana Leinonen and Jim Munroe that relies on a WYSIWYG browser editor and a “word-on-word mechanic.” Texture Writer is not easily accessible to those with visual or motor impairments, as it requires the ability to navigate precisely with a mouse and lacks keyboard compatibility. Click here to access the “companion” booklet that contains the full transcript of Hollow Me. The transcript is organized by Action Behaviors and their consequences.