Laura Kalas’s new study of Margery Kempe within the context of medieval medical thought and practice deserves a place in the pantheon of other transformative studies of Kempe’s Book. An engaging through-narrative of Kempe’s life and spiritual development, taken in tandem with one another, and with ample contextual support in medical and theological treatises, this study establishes important cultural and theoretical grounds for our reading of Kempe’s suffering, as well as contributing to the growing field of medical humanities.

Kalas begins with a recipe for medicinal spiced sugar candies, “dragges,” found on the final folio of the British Library manuscript that holds the single complete copy of The Book of Margery Kempe(BL Add. MS 61823). Made legible only with multi-spectral imaging, and added to the manuscript a few decades (probably) after the Book had been recorded in the early to mid-15th century, this recipe appears to be a suggested cure for Kempe’s ailments, perhaps the “flux” specifically, or more generally her melancholic imbalance, which could be corrected by the sugar’s cooling properties. From this auspicious start (some of this material was also published in Studies in the Age of Chaucer 40 (2018): 155-90), Kalas opens her consideration of Kempe along several distinct but related lines: the stages of her biological life-course, the stages of Kempe’s deepening role as a wise holy woman, and the degree to which both of these developments may be situated within the experience of bodily pain.

In the first chapter, on melancholia, Kalas explores the nexus of surplus melancholic black bile, the cooling and drying effects of Kempe’s copious tears, and a uterine disorder, a “suffocated womb”(43), which was believed to produce swooning and fainting. Resisting a modern medicalized reading of Kempe’s behavior, however, Kalas finds reason to link Kempe’s physical behavior and apparent humoral imbalance with Kempe’s focus on Christ’s passion and tears. Tagging Freud’s theory that melancholia “behaves like an open wound” (29), Kalas connects Kempe’s tears with a “cycle of traumatic repetition” (58), which serves as a means toward her spiritual union with Christ.

One of the strengths of Kalas’s study is her ability to negotiate several paradoxes present in medieval culture, including what she terms the “sexual paradox” for women, specifically the “pain paradox of marriage” (62), explored in chapter 2. While theological texts touted the spiritual benefits of sexual abstinence, medical texts advised that abstinence could be harmful to female health, leading to unspecified “grave illness” (“grauem...egritudinem”) (62). Spiritual and physical pain, thus color both personal choices available to Kempe while still married, making pain inevitable for her. Kempe’s near-death experience after the birth of her first child similarly situates Kempe at the intersection of physical and spiritual pain, as she is both excluded from female-centered post-partum care and from the comforts of church confession and ritual. This, argues Kalas, establishes a pattern for Kempe that extends through her spiritual marriage to the Godhead in Rome, where she still desires an “embodied and transcendent union” with the “Christic body” (93).

Chapter 3, “Lost Blood of the Middle Age: Surrogacy and Fecundity,” explores Kempe’s development during her menopausal transition to an authoritative role based paradoxically on maternal surrogacy. Noting that menopause could be seen to counteract the humoral imbalances of menstruating women, Kalas finds several examples of Kempe’s emergent spiritual fecundity. In the subsequent life-transition to widowhood, Kempe then continues to serve as a maternal surrogate for others’ pain, and evolves into an acknowledged healer, an elder holy woman to whom others turn for spiritual guidance and cure. Examining instances of lepers that Kempe encounters (chapter 4), Kalas focuses on the story of Kempe’s adult son, which opens her Book II. Over an extended passage, Kempe details her son’s sinful fall into lechery, his resulting leprous appearance, his asking his mother for help, as he “trustyd be hir preyerys to be deliueryd þer-of” (The Book of Margery Kempe EETS vol. 212 [1940], p.222), her words of correction to her son and subsequent prayers on his behalf. Several years later he is reported to be cured; in addition, he has himself turned toward God, and apparently he becomes Kempe’s first amanuensis. Kalas further argues that the death of her husband, probably in 1431, “heralding [Kempe’s] literal widowhood, is a deictic devotional turning point..., a transformational apotheosis” (159).

A further development of Kempe’s role as surrogate is as a “death surrogate,” outlined in chapter 5. Visions of Christ’s Passion lead Kempe’s pain surrogacy to its “logical conclusion...Kempe’s willingness to become a death surrogate for Christ” (161). Acknowledging the difficulty of establishing a reliable chronology of Kempe’s Passion visions, Kalas nevertheless contends that most collect toward the end of her Book and have “a distinctively climactic feel” (165). Kempe’s own experience of illness and pain, as well as her observation of others’ pain and dying, work to connect her with the Virgin Mary at Christ’s Passion, an integration of herself into the Passion scene as it unfolds before her, in art, in street drama, in her own reported visions. Reinforcing her maternal role, this identification with Mary then allows her intimate access to Christ’s own pain.

Chapter 6 treats Kempe’s old age and the writing of her Book as closely allied with her deepening authority, as a memorial project in Kempe’s final stage of “aged asceticism” (183). The aged, diseased body, considered incurable, dovetails with Kempe’s role as a wise “eldmodyr” (192), serving an important cultural function. As in earlier chapters, and citing De secretis mulierumspecifically here, Kalas connects the expected weakening heart of old age (“syncope”--fainting) with the uterine suffocation suggested earlier in her argument as one of Kempe’s ailments, with a possible increase in “mystical perception” (197), associated in De secretis with aged hearts. These linkages between the body and the spirit, Kalas contends, suggest that those who find Kempe’s later years to be marked by a dis-embodied state are missing a crucial aspect of her lived experience (201). As Kalas forcefully puts it, the Book is “an account of active, measured, and demonstrative humanity fueled with kinetic force” (203), located in the embodied female voice of her text.

As may be evident in this brief outline, Kalas’s argument depends on a chronological reading of Kempe’s lived experiences and spiritual development, much of which can be hard to establish with any certainty, except in broad outline. In addition, as with all autobiographical works, we know only what the author wants us to know, and we may suspect that the narrative represents an idealized life-course, or at least one that leads to a desired conclusion. For Kempe, with scant independent historical documentation, we cannot confidently verify many dates exactly, and so we must speculate on the “when,” as well as the “why,” for several of Kempe’s life experiences.

Still, in broad outline, the pattern Kalas presents does hold (young wife, to mother, to widow; youthful convert to elder holy woman), and thus, despite the speculative nature of some of Kalas’s assertions and assumptions, the over-arching argument brings the dominant pain narratives of Kempe’s book to the fore. How Kempe’s suffering intersects with the “medieval imaginary” (31) of medical and theological thinking in her time and place is a significant contribution to our understanding of Margery Kempe in all her complexity.