Kate Kennedy’s “Skin” is a slim book, but its impact is anything but. Its subject is a focused one, and its actions play out over the course of a relatively concise period of time. And yet it resonates in powerful and unexpected ways. From Kennedy’s choice of words to the distinctive portraits of people she met during a time of crisis in her life, there isn’t a wasted word – and the results make for an intimate, visceral and moving work of nonfiction.

Cover courtesy of Littoral Books

At the heart of the book is the Maine writer’s treatment for skin cancer, beginning with her doctor’s discovery of it on her face and progressing through her treatment, with many ups and downs along the way. Through her use of precise language, Kennedy gives the reader a memorable sense of the qualities of the different aspects of her experience, from the mask she wears while being treated to the mark on her skin that first prompted medical attention: “a white tidbit, the size and texture of a freshwater pearl, had appeared within the corona of sun damage.” It certainly seems innocuous, based on that description; for Kennedy, it’ll be anything but.

Shortly after, Kennedy alludes to another feeling of discomfort. “The area between my cheekbone and left ear felt nettled, a bit redder and itchier than the surrounding skin,” she writes. “Still, hardly noteworthy.” But soon, the area she describes will turn out to be a sign of a more worrying diagnosis. And as the book progresses, Kennedy and her doctors explore surgery on her face – first to remove the most noticeable aspect of the cancer’s presence, and then to further address its spread on her cheek.

The options prompt Kennedy to ponder her own face, the possible loss of expression that could come from skin grafts or radiation treatment, as well as her family’s history with cancer. As her treatments become more of a regular occurrence, she offers memorable portraits of the other patients she encounters. Here, too, Kennedy uses her penchant for linguistic precision to memorable effect, including one brief foray into the absurd, when she ponders a fellow patient’s face mask.

“Walking closer to the couch by the fireplace, I asked the man if he had plans for his mask,” she writes. “I imagined it transformed into a Chia Pet dotted with green sprouts instead of hair, or maybe hanging upside-down on hooks, with tomato vines dangling to the ground. But those pictures, instead of lifting my spirits, sorely grieved me.”

Kennedy nimbly juxtaposes her own medical concerns with her husband Nate’s travails during the same period. He, too, struggles with health issues – not as serious as a cancer diagnosis, but frustrating in their elusiveness. A significant subplot in “Skin” finds him preparing for a garden tour, and working to cultivate certain plants around their home and prune back others. It isn’t quite a direct parallel to Kennedy’s experience with cancer treatment; instead, it feels more like a rhyming experience or an echo of it, placing both within a larger context.

Kennedy spent half a decade directing the Southern Maine Writing Project at the University of Southern Maine, and her command of language and tone makes for a memorable read. Her use of language also works on a deeper level, however. For much of the book, Kennedy’s doctors struggle with one of the challenges of treating cancer: the fact that there isn’t a clear way to know when cancer has been successfully excised from the body, or that it definitively won’t return. The precision of her language exists in a sharp contrast to this – essentially, it can achieve a level of specificity that medical science cannot.

In this way, then, Kennedy’s precision in writing this short memoir can be seen as a kind of act of defiance – or at least an intentional process of contrasting the medical horrors she went through with clear and unambiguous language. By the end of the book, the reader is left with a haunting portrait of a few years in one writer’s life. In the midst of a narrative abounding with disease, death and insecurity, those glimpses of the quotidian and the enduring feel nothing short of inspiring.

New York City resident Tobias Carroll is the author of three books: “Political Sign,” “Reel” and “Transitory.” He has reviewed books for The New York Times, Bookforum, the Star Tribune and elsewhere.

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