Samina Ali | The PEN Ten
When writer Samina Ali went into labor, following a pregnancy filled with doubt, dread, and dismissive doctors, she was prepared for the worst. Waking up post-labor, the worst was just beginning. Owing to an unchecked health condition, she had lapsed into a coma with most of her organs failing, including severe brain damage–she had nearly died, but had miraculously survived. Writing the story about 25 years since the incident, Ali’s latest, Pieces You’ll Never Get Back (Catapult, 2025) is a memoir exploring the days before and the years after an astonishing incident that left her without recognition of her own child and husband, language other than her native Urdu, and mobility.
In an interview with PEN America, Ali shares how spirituality, motherhood, and writing helped her through her toughest moments as she pieced herself and her life’s narrative back together. (Bookshop, Barnes & Noble)
The book opens with the moment you chose Ishmael as your child’s name. From then on, literature and religion are entwined in your book, extending from the spiritual practices of both Buddhism and Islam in your life. Why was it important for you to open this book with spirituality?
I absolutely love that this is your first question because this is one of the most important messages I’m hoping to convey with this memoir. Although the central story is about my recovery from the complete collapse of my body (multiple organ failure, brain damage, heart damage, vasculature damage, etc.), my ultimate purpose was to express how my encounter with death fundamentally changed how I live. My brain damage showed me how so much of our identity – our ideas about who we are and where we belong in the world – is nothing more than the wiring in our brains. And that wiring in our brain is the result of what we’ve been taught growing up by our parents, teachers, the wider communities we live in, as well by as our past experiences – and, importantly, the meaning our brain then assigns to those past experiences.
One of the most unfortunate things all of us have been taught is that the differences in our skin color, economic standing, cultural background, gender, or our faith make some of us inferior to others. Our differences have long been weaponized to sow divisions. An experience with death shatters these demeaning notions, renders them meaningless. We are matter and energy, all of us, united as one humanity at the most intrinsic levels.
The Qur’an emphasizes the beauty of diversity: the diversity in nature, the diversity in races, and even the diversity in beliefs. It embraces differences as essential to living rich lives. While I speak to Islam and Buddhism in Pieces You’ll Never Get Back, I also write about attending a Catholic school and taking Bible studies classes and attending mass. I reference Judaism and Zoroastrianism. Each of these religions is rich and beautiful and, while we think of them as distinct, I trace their roots back in history to show how these different branches of religions exist on one, singular tree. The Bible says, “In the beginning was the Word, and the Word was with God, and the Word was God.” Similarly, the Qur’an refers to Jesus as the “Word of God.” Muslims also believe that the Qur’an is the word of God. Words, God, spirituality, the books of revelations, and books in general are linked in my mind. So, I open my memoir in this way both an invitation to readers to enter my world and also as a reminder of our commonalities and connections.
How did relearning to use language, just as your son was learning his first words, change or shape your approach to language and literature, and by extension to motherhood?
When I lost my ability to speak and write, I’d also lost my higher mental processes to think, to imagine, to create – those abilities that are intrinsically human, separating us from animals. I felt lost then, unmoored. It was one of the darkest periods of my life. While I still experience moments of aphasia when writing and speaking, losing my ability to speak properly in English taught me the importance of words. Think about how magical language truly is. We are able to make sounds with our mouths and tongue that have meaning, not only to us but to those around us. Letters are symbols that, without our mutual agreement, would have no meaning or purpose. How amazing! Think how lonely and myopic our experience of this world would be if we were unable to communicate with one another, to make connections – not just by speaking, but by putting words down. That’s where I lived during one of the darkest periods of my life.
Because I happened to be raising a newborn while recovering from brain damage, I had to make the difficult choice of what language to use with him. My parents only speak to me in Urdu, which is my first language. And because I was raised speaking Urdu, I felt most natural speaking to my own son in Urdu. It would have been easiest as well since my Urdu was left undamaged. But it was for that very reason, because my Urdu remained fluent, because my English – my second language – was broken, that I knew I had to fix it by forcing myself to speak it. So, I made the heavy decision to speak to my son not in my native tongue but in my adopted language, English. I knew it meant he’d grow up not knowing Urdu.
Who I am in Urdu is different than who I am in English, so for years and years I was bereft that my son didn’t know my full identity. Much to my delight (and relief), when he was in college, he learned Urdu on his own, so now we can speak in both languages. The first time we had a conversation in Urdu, he told me that he felt like an entire world had opened up to him and he saw aspects of my personality that he’d never known existed. Suddenly, when he was in his early 20s, he saw me as an entirely different mom than the one who’d raised him.
We experience the world through our brains, streaming sensory details. The color of flowers and birds. The poetry of music. Laughter. So, what happens when the brain is damaged and the world tilts sideways and our experiences turn flat and meaningless, no longer matching up with the colorful world around us?
In a book about medical recovery, it is easy to get lost in overwhelming medicalese. However, in your writing you poetically interweave it with and through your memories. How did you approach including medical jargon and processes in your memoir? Was there a balance you tried to strike to keep the writing from being too dense?
The first person to tell me to write this memoir happened to be my neurologist. At our final meeting 3 1/2 years after my son’s delivery, we discussed what might have contributed to my recovery. When I told him that I’d written a novel, he was struck with the idea that I might write about my recovery. He said that doctors could explain what’s happening inside a damaged brain only from the outside, based on medical books and practical experience working with patients, but that I could write about it from the inside. He imagined it might be useful. It took me many years to feel like I could write about my journey. When I finally sat down, I used his comments as a guide. While it’s true that every patient with brain damage recovers differently, it was important to me to capture as best I could how it feels to have brain damage: the disorientation and frustration and fear and anger and even arrogance. It’s an isolating, lonely experience.
We experience the world through our brains, streaming sensory details. The color of flowers and birds. The poetry of music. Laughter. So, what happens when the brain is damaged and the world tilts sideways and our experiences turn flat and meaningless, no longer matching up with the colorful world around us?
You write that you scrapped the entire manuscript of the book you were working on before you went into labor because it was unrecognizable to you after. Did you notice any changes in your writing style from your previous work to now? How did your journey to recover the language(s) you lost impact your writing style?
I actually scrapped the draft of my novel, Madras on Rainy Days, in the months following my delivery because, through the brain damage, I no longer recognized it. The draft felt alien to me, as though I’d taken a random book off my bookshelf and begun reading. It wasn’t my novel anymore. And that frightened me. I was afraid the neurologist was right and that I would never be able to write again. Too frightened to confront that truth, I simply deleted the book and started again. For years after my novel was published, I couldn’t go back to writing again. Every time I imagined myself sitting down to write, I had the image of me writing through brain damage: the excruciating headaches, the words that emerged on the page that were different from words I was intending. Since I was struggling with English when writing the novel, I heard the novel in my head in Urdu. All the characters spoke in Urdu. The narrator spoke in Urdu. To write my novel, I had to first translate the Urdu to English and then type the English onto the page accurately through the aphasia. Part of my journey to re-master English meant that I had to live inside English, speaking it to others, speaking it to my son, and speaking it to myself. Over those years, that meant that I gradually stopped thinking in Urdu and started thinking in English. When I wrote Pieces You’ll Never Get Back, I heard the words in English and, for the most part, I accurately typed the words in English through whatever remnants of aphasia I still experience.
In the end, you attribute the credit of your recovery to the practice of writing your book every day which stimulated and triggered memories and imagination. How important is having a writing routine and what does yours look like today?
Writing a book demands a daily writing routine. It’s not just about training writing muscles to string words and sentences together with more ease, it’s about remaining inside the world of the book. When I’m in the midst of writing, I’m most terrified by school holidays: summer, winter, spring break!! My son is now grown and independent, but I have a daughter at home, and any break from school means an abrupt, jolting stop to work. It’s the thing I dread the most.
We can’t force ourselves to stop grieving or to stop being angry or to stop being in pain. We have to learn to be patient and kind with ourselves. We have to give ourselves grace. I wrote and I cried, and I cried and I wrote.
As an award-nominated fiction writer, why did you choose to tell this story as a memoir? Did you find it hard to resist the urge to fictionalize or did this flow freely?
I not only was trained as a fiction writer, but I also teach fiction writing! That made the process of writing a memoir incredibly difficult. All too often, I found myself turning to fictional craft, creating scenes and dialogue and trying to show what happened rather than just coming out and telling it. It was actually the biggest hurdle I had to overcome this time around. Draft after draft after draft, I had to fight against my own impulse to craft scenes. Writing memoir is an entirely different skill set, and I had to teach myself that skill set while writing the memoir. It wasn’t easy.
This book has been more than 20 years in the making. How has it changed over the years and why was now the right time to publish it?
My neurologist told me to consider writing the memoir when my son was 3 1/2 years old. I left that conversation thinking, “Hell no. I’ll never write this story.” I wanted nothing to do with this story. I didn’t want this story to be my story. Writing a memoir would make it mine.
When I became pregnant with my daughter, I knew there was a chance I wouldn’t survive the delivery. It suddenly felt urgent to write the story, to leave a legacy for my son, who was almost 9 years old at the time. That story was never formal. I handwrote my memories in a journal. After my daughter was born, I put the writing aside because I wanted to experience motherhood, something I hadn’t the first time around. But every moment I spent with her was a reminder of those moments I’d lost with my son. Like that, the trauma of his delivery continued to impact me in different forms throughout my life. We believe healing should end at a certain point, but we carry our losses and our pain and our struggles. About six years ago, when I finally got serious about writing the memoir, I was astonished to discover that eclampsia was still the most common complication of pregnancy. We still don’t know what causes it. Women are still dying from it. The U.S. is the only developed nation where the maternal mortality rates are rising. How could this be possible, 15-20 years after I delivered? With a heavy heart, I have to admit that my story is still timely.
Writing about trauma, especially when it is personal, can be extremely taxing. What are some strategies you adopted while writing this book to help you dissect your emotions while preventing distress?
I’ve learned that the body releases emotional pain when it’s ready. We can’t force ourselves to stop grieving or to stop being angry or to stop being in pain. We have to learn to be patient and kind with ourselves. We have to give ourselves grace. I wrote and I cried, and I cried and I wrote. Traumatic experiences can be so intense that writing or speaking about the experience makes us feel like we’re reliving it, like we’re back there again. It doesn’t take much for the trauma to overwhelm us. There’s no way to prevent the distress. The only thing you can do is mitigate the intense emotions by limiting how long you stay in that space.
I knew this story couldn’t be told as a straight narrative, but my brain was stuck in “novel-mode,”and I couldn’t think outside that. When the breakthrough finally came and it struck me that I had to break open the book so that the chapters mirrored the different islands of my broken brain, coursing back and forth in time, presented as long and short, as though the narrative itself was shattered, I felt such overwhelming joy.
Congratulations on all your efforts to promote women’s equality and fighting against injustice. What are your thoughts on a world that is increasingly threatening free speech and expression, be it banning books or imprisoning writers?
Having fought as hard as I did to regain my abilities to communicate properly in English, it makes me so sad to see how we abuse language. We post unnecessarily cruel comments online. We spread false news and lies. We rouse up fear and create divisions. We threaten people into silence. We ban books simply because we disagree with the author’s message. We repeat lies until they become truths as a way to control others.
As a culture, we’ve lost our connection to language. We no longer know how to have healthy and respectful dialogues, how to converse across differences. It’s a stark world where we believe that our only responsibility to language is to express such extreme ideas that we gain followers. There was a time when the world was whole, and my brain was broken. Now my brain is whole, and the world is broken. Communities not just divided but pitted against one another.
After 9/11, the anti-Islamic rhetoric raging across the Western world made Muslims out to be barbaric. Islam, we were told, was a religion that deprived women of their basic rights over their bodies. The U.S. was going to invade Afghanistan to liberate the Muslim woman. A few Muslim-majority countries were rightfully condemned for imprisoning writers and censoring speech and controlling media. Dictators were in charge. Police and courts were under their control. Democracy and free elections were desperately needed. I remember the hope the world felt when the Arab uprisings started happening – thanks in part to people being able to organize on Twitter. Great efforts were made by Western thinkers to establish that there was a true clash in civilizations between the Western, civilized world and the barbaric Muslim world. What does it say about who we are as Americans that we seem to be perilously and even purposefully heading toward enacting the very injustices and intolerances we claimed to stand against?
What did you enjoy most about writing this book? And if your son has read it, what was his reaction?
I often joke that this book was as traumatic to write as my son was to deliver. That’s because it was an emotional journey and because, as I spoke to earlier, my own struggles over learning how to write a memoir and also because I wrestled with the structure for years. I knew this story couldn’t be told as a straight narrative, but my brain was stuck in “novel-mode,”and I couldn’t think outside that. When the breakthrough finally came and it struck me that I had to break open the book so that the chapters mirrored the different islands of my broken brain, coursing back and forth in time, presented as long and short, as though the narrative itself was shattered, I felt such overwhelming joy. All the stagnant energy I’d accumulated over the years of struggling with the structure suddenly had an outlet and came gushing out. I sat down and rewrote the entire book in six weeks. It was so much fun … finally!!
My son lives in London, and I just mailed him a copy this week. I told him that I wanted him to read the story not with sadness over what I’d gone through but with the sense of awe for the miracle that is us.
Samina Ali is the author of Madras on Rainy Days, which won the French Prix Premier Roman Etranger Award and was a finalist for the PEN/Hemingway Award in Fiction. She is also a recipient of a Rona Jaffe Foundation Writers’ Award. She is a public speaker, and her Tedx talk, “What the Qur’an Really Says About the Hijab,” currently has over 8 million views. Her writing has been featured in various outlets, from national NPR to The Economist.
