Reading Group Guide

INTRODUCTION
At age forty-four, playwright and solo theater artist Alice Eve Cohen was happier than she'd been in a long time. After a difficult divorce and painful custody battle for her adopted daughter, and years of financially challenged single parenthood, she was engaged to Michael, a younger man who inspired her artistically and nourished her emotionally. Her career, too, was blossoming.

Then, as if on cue, her luck seemed to turn, and she started feeling ill. At first, the series of mysterious symptoms — fatigue, depression, insomnia, a hardening in her abdomen — didn't seem to concern her doctors, who assured her it was the onset of menopause and instructed her to continue taking the estrogen she'd been on since being told she was infertile at the age of thirty.

When the symptoms worsened, she was certain that she had a tumor. She returned to the hospital and was finally sent for an emergency CAT scan that revealed the true source of her symptoms: she was actually six months pregnant.

As Cohen and her family grappled with a reality she never thought possible, the revelations that followed posed new and complicated challenges. With no prenatal care, a shoddy freelancer's insurance plan, and a pregnancy that was characterized as high-risk, she was turned away by the very specialists she needed. It was far too late for an abortion — unless she wanted to travel to Kansas and face down a fierce crowd of protestors. At the same time, she was overwhelmed by her child's potential health problems that would likely be caused by the hormones, her advanced maternal age, and other factors. She was, in fact, fairly certain she did not want to have a child, even as her partner, family, and friends urged her to embrace her strange luck. As the days of her pregnancy tick away, she ponders her options and the challenges ahead. The more she knows, the less she understands, and every piece of new knowledge seems to stir the very foundation of her beliefs.

In What I Thought I Knew, Cohen has applied her theatrical sensibility to create a page turning thriller of a memoir. Cohen's journey through a broken healthcare system and the farthest reaches of her own spiritual faith is laden with memorable characters and surprising twists and turns. A powerful story with an endearingly honest heroine, and rich insights into family relationships, What I Thought I Knew is timely, compelling, and utterly unforgettable.

Alice Eve Cohen is a playwright, solo theater artist, and memoirist. She has written for Nickelodeon and PBS and received fellowships and grants from the New York State Council on the Arts and the National Endowment for the Arts. She teaches at The New School in New York City.

I quickly discovered that I wasn't ready to contemplate performing this story for an audience. It was too raw, too frightening. At that time, I could barely talk about the story, no less perform it. Performance is so public; my story is so private. Writing the book allowed me to work through my personal struggle with the material by removing the terrifying prospect of performing. The particular intimacy of memoir allowed me to imagine, while writing, that I was sharing my secrets with just one reader at a time.

Structurally, my book is deeply influenced by theater. It's written in three acts with an epilogue. Each act is divided into scenes. The action of the scenes is revealed through dialogue, and the reflective narrative throughout the book is similar to solo theater monologue. The three act structure gave me a container in which to shape my unruly collection of experiences, thoughts, and feelings into a coherent whole. The dramatic structure also helped me figure out the where my story began and ended — which eluded me for a long time.

Q. The premise of this book might be summed up in the Yiddish proverb "Man plans, God laughs." Do you think being at least culturally Jewish prepared you for the ironies of your experience?

Whether or not it's a Jewish trait, my preferred survival mechanism is to find humor even in the most painful situations.

Q. Your experience with the healthcare system really seemed to hit some highs (brilliant experts, kindly doctors who extended themselves) and lows (bureaucratic insurance nightmares, malpractice). How did it change your perspective as a patient?

There are good guys and bad guys in my story, from all corners of the healthcare system. My health insurance company was woefully inadequate, and some doctors made idiotic mistakes. But I also encountered brilliant doctors and therapists who were selflessly dedicated to their patients.

My experience has changed my perspective as a patient in a variety of ways, including making me a fervent advocate of healthcare reform. I used to trust my health insurance company, until I discovered that in order to provide adequate medical care for my daughter, we would have to go deeply into debt. I have become more careful about choosing doctors. I ask a lot of questions, and I am likely to seek second and third opinions on medical advice for me and for my family. I admire and trust my current doctors. At a certain point, unless you're a medical expert yourself, you have to trust your doctor. But I emphatically do not trust the health insurance industry, which is so intrinsically flawed that only health care reform can repair it.

Q. So many of the characters you encounter along the way, from the Lamaze coach to Dr. Arborgast, the Russell-Silver specialist, are so vivid. Have you ever incorporated any of these personas into your stage work?

I've adapted portions of What I Thought I Knew for the stage, and I've done a number of performances and theatrical readings. There's a lot of humor in the book, and the comic scenes with larger-than-life characters, such as Dr. Arbogast, are the most fun to perform. Soon after my book came out, Eliana had an appointment with Dr. Arbogast (not her real name), and I worried that she might be angry about my portrait of her. To my happy surprise, when we got to her office, she was holding a copy of my book, which she asked me and Eliana both to sign, and said she thought her scene in the book was hilarious.

Q. This book is filled with extremely candid emotions that other writers might have shied away from. Were you as open in the early drafts or did you come to reveal more of these feelings over time?

From the start, I was writing to figure out what had happened, and the only way I could do that was by being uncompromisingly honest with myself. I didn't know it would be a book. I thought it might be a collection of essays, and I wasn't thinking about publishing. I wrote in secret — not even telling my husband what I was working on — so that I wouldn't be inhibited by the thought of an audience. I experimented with ways to capture my most desperately confused moments. In the later drafts, I think I was able to articulate more complicated emotions, because through the process of writing the book I finally was able to understand what happened.

Q. You've tackled some weighty issues here, from late-term abortion to "wrongful life." What has the response to the book been?

Reviewers and interviewers often highlight the abortion decision and my wrongful life lawsuit, and I'm grateful for the opportunity to be part of the national dialogue about reproductive rights. I'm thrilled at the positive response my book has received in the press, and especially touched by reader responses. Many readers have written to say that they, too, have wrestled with impossibly difficult decisions — including abortion — and they appreciate my giving voice to subjects that are so often kept secret. I received an e-mail from a woman in Wichita, Kansas, who said she "hadn't been involved in Wichita's angry confrontations — on either side of the abortion issue," and that my book gave her "new insights into the heartbreaking decisions that women sometimes face, regardless of the choice they make." It's very fulfilling to know that my book has started discussions, invited reflection, and offered readers a new way of thinking about these issues.

Q. A beautiful theme running throughout your memoir is your connection to your theater students — particularly Dani. Does teaching parallel motherhood, or does your relationship with your students represent another kind of love?

That's such an interesting question. I hadn't thought about it quite in those terms, but the strong bond I had with my students, and my relationship with Dani, are important threads in my memoir. I had just begun to teach solo theater, and I really loved my students. The class was my lifeline during that difficult period of time. There was an intuitive understanding in the room that the stakes were very high: life and death. I was having a baby, Dani was dying, and the students approached their solo pieces as if their lives depended on it. It was a very supportive group, Dani especially. She nurtured everyone's work, while at the same time developing a beautiful dance-theater piece about her terminal cancer. Her kindness and grace in the face of death, her unexpected new reality, inspired me to change my perspective and make some first, halting steps toward accepting my unexpected new reality. I hoped I would be able to embody the kind of courage and generosity of spirit Dani exemplified.

I often think about Dani. I teach playwriting and solo theater at The New School, and I tell my students about Dani and about the April Fools party she threw shortly before her death — her final performance, a celebration of life, and her good-bye.

Q. Of all the advice people give you in the book, one of the most profound statements is "Parenting is all about moving forward and constant, unpredictable change." Has this idea helped you as you continue to raise your daughters?

I've often thought of that wise piece of advice as my daughters have grown up. It's a variation on a theme: "Mom plans, God laughs."

Q. Even though your personal story is extraordinary, readers can relate to that feeling of being blindsided by an unexpected reality that changes everything we took for granted. Do you think these realizations always make us stronger?

I imagine that the book will speak to anybody who's been through difficult times — which includes just about everyone. I'm fortunate that our family crisis and our new understandings that came out of it did ultimately make us stronger. There were times in my journey when I feared for my daughter's life and for my own. Somehow, my family, my marriage, my children and I all survived and thrived, despite (or maybe because of) the storm we weathered together.

However, the new insight that comes from being blindsided by an unexpected reality does not always make us stronger — and this brings me back to healthcare reform. A medical crisis can transform what you once took for granted about yourself and about the world, but the consequences can be devastating, especially when the healthcare system isn't playing fair.

Q. As you condensed your wildly complicated story into What I Thought I Knew, did you find that it made sense in ways it hadn't before? What was your biggest takeaway from writing this book?

Writing the book helped me work through and come to terms with a period in my life so confusing and troubling that I couldn't talk about it for years. In the epigraph, I use a quote from Zora Neale Hurston — "There is no agony like bearing an untold story inside of you" — which has powerful resonance for me. After bearing this untold story inside me for seven years, I'm glad I found the way to tell it, and grateful that the story finally has an audience.