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Hesitation Wounds: A Novel

Who heals the healers? It’s the underlying question in much of medical- and psychiatry-inspired pop culture, from Grey’s Anatomy to Good Will Hunting. We are enamored of the damaged doctor, the depressed therapist, and the nurse with a drug habit because their stories humanize those who might otherwise feel unassailable. Susanna Seliger, the protagonist of Amy Koppelman’s Hesitation Wounds, is one such doctor.

Susanna treats cure-resistant depression via electroconvulsive therapy. On the surface, she is a consummate professional and put-together middle-aged woman living in New York City with her long-term partner, Evan. The reader, however, sees little of this smooth exterior. As the novel dwells completely in Susanna’s consciousness, we are instead party to her most private thoughts and emotions, the circular nature of her memory, the interruption of her daydreams, and the vivid imagery of her deep sleep. Susanna is first and foremost a woman overcome by grief, particularly the deaths of her father and brother during her adolescence, but also the recent deaths of her elderly mother and one of her patients.

This experience of grief dominates the text, and for that reason Hesitation Wounds is not an easy read, despite its comparatively short length. This is not to say that it is not worth reading, however — only that readers dealing with their own depressive feelings might tread cautiously as they peruse the book, much in the way they might with I Never Promised You a Rose Garden, Girl, Interrupted, Speak, and other similar texts. There is much here that resonates with all of us who have lost loved ones and so we may experience Susanna’s story with that significant sense of recognition that makes literature powerful. But because the book deals frequently with the issue and question of suicide, it may not be the right book at the right time for all readers.

“This is what I know: The people who love you leave,” Susanna informs us in the opening line of the novel. “But you already know that. We all think we know.”

Grief is, by her account, a constant in our lives, and the structure of Hesitation Wounds certainly echoes that sentiment. The narrative does not progress in a linear fashion; rather, it circles back to events, revisits them, and reveals other details. Although the death of Susanna’s brother, Daniel, dominates the book, we do not know the specific details of this moment until the third and final section. There is a distinct emotional truth to this approach, that recovering from grief is rarely a linear process, that some days the intensity of it returns full force, no matter how long it’s been.

Moreover, the novel shows how grief impacts our relationships, as it does for Susanna with Evan, whom she leaves after he is unfaithful; her first lover Ray, whom she befriends later in life; and her patient Jim, whom she confides in and comforts.

Despite this pervasive expression of grief, Hesitation Wounds does not leave us hopeless. It’s true that it offers no comfort in the metaphysical, as more than one character identifies as strongly atheistic. Instead, Koppelman preoccupies herself with how we might find joy again in our lives.

For Susanna, that joy takes the form of an adopted daughter, Mai. This choice might make a few readers wary: obviously children are not a wholesale solution to loss. But Koppelman rightly emphasizes that Mai is Susanna’s specific desire, not that of all individuals struggling with grief and depression. Nor does the narrative present Mai as a cure-all. In the final scene of the novel, she accompanies Susanna to the cemetery where Daniel is buried. Mai, who still does not have a full grasp of the language, intuits her adopted mother’s feelings of loss and stands close to her. As it begins to snow, the two of them catch the falling flakes on their tongues.

It’s an uplifting scene, to be sure, and has the promise of life begun again, but the location of this moment reminds us that the pain of loss is never fully vanquished. Rather, it must still be felt and acknowledged. And then it can only be assuaged through our own connections to the people we bring into our lives.

There are no perfect solutions in Hesitation Wounds, and that, to me, rang most true in the novel. Indeed, the trappings of the story — Susanna’s profession, Daniel’s counterculture demise — felt incidental next to the emotional resonance of the experience of grief. These details may in fact be the most divisive for interested readers, whether they see them as an integral part of the narrative or a clever conceit.

The novel is deceptively dense due to its rich psychological interest. Consequently, as I’ve noted, it does not feel like light reading. Koppelman’s use of imagery and structure are quite successful overall. However, there are instances when the reader may feel confused or alienated by her stylistic choices. In the vein of similar novels, perhaps, Hesitation Wounds requires a state of mind receptive to the immersive experience of the text. But that receptiveness is, on the whole, rewarded with a deeply resonant narrative — and a meditation on the nature not of only of our grief, but our humanity.

Hesitation Wounds: A Novel

The Overlook Press, November 2015

Hardcover, 192 pages


Hesitation Wounds: A Novel

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Julia Patt

APA Reference
Patt, J. (2016). Hesitation Wounds: A Novel. Psych Central. Retrieved on November 26, 2020, from
Scientifically Reviewed
Last updated: 23 Feb 2016
Last reviewed: By a member of our scientific advisory board on 23 Feb 2016
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