The Tiger and the Cage: A Memoir of a Body in Crisis 

By Emma Bolden  

Soft Skull Press, 2022 

Paperback: $17.95 

Genre: Memoir 

Reviewed by Sarah Cheshire 

Cover of THE TIGER AND THE CAGE by Emma Bolden. Cover image shows a fragmented illustration of a woman in profile. Color field is tan, blue, and brown.
In 1900, a teenage Viennese girl, known pseudonymously as “Dora,” was sent by her father to see Dr. Sigmund Freud after experiencing years of “unilateral headaches… [resulting] from attacks of nervous coughing,” which had been written off by her family physician as “purely nervous.”1 After months of psychoanalysis, including a deep dive into Dora’s first sexual experience—a non-consensual encounter with an older family friend—Freud concluded that Dora’s cough was psychosomatic: a physical manifestation of deeper repressed trauma and emotional unrest. Dora later became the subject of Freud’s seminal Fragments of an Analysis of a Case Study in Hysteria, a text which helped cement within Western Medicine a tradition of dismissing women’s health concerns as the product of psychological imbalance.  

While reading Emma Bolden’s The Tiger and the Cage — an exquisite memoir chronicling the author’s experiences navigating a deeply misogynistic medical system while dealing with chronic reproductive illness — I couldn’t help but observe a throughline between Emma and Dora’s stories. Although the products of vastly different eras and geographies, both women embody an all-too-familiar archetype: the silenced woman whose pain is pathologized rather than heard.  

Bolden’s story begins thousands of miles and dozens of years from Freud’s Vienna office, in 1990s Birmingham, Alabama. Like Dora, Bolden’s symptoms started with a hacking cough, a feeling that her “throat was full of dirt” (p. 29), which came on suddenly, also shortly after a series of unsettling interactions with an adult figure in her life. When a doctor fails to find a medical explanation for her cough, Bolden encounters, for the first time in the book, a blurred boundary between the faculties of her mind and her body:  

I don’t know what I want to remember: that I was faking it, which means that I did have control over my body even if I didn’t have control over my emotions, or that I wasn’t faking it, which means that I didn’t have control over my body or my emotions. (p. 31)  

As Bolden’s narrative continues, she finds herself trapped in the same cycle as Dora and many other women– her body speaks, but the language is either intentionally stifled or lost in translation as she flounders to communicate the severity of her symptoms. Recalling her first medical appointments after experiencing mysterious fainting spells as a teenager, Bolden describes the seemingly well-intentioned doctors’ reactions as: “They didn’t believe me, exactly. They believed me inexactly” (p. 53). At worst, Bolden is confronted by doctors who either chalk her symptoms up to presumed psychological trauma or, in one case, terminate her as a patient for refusing a hormonal treatment known to cause life-threatening long-term health issues. 

Although Bolden is eventually diagnosed with dysautonomia and pervasive endometriosis, The Tiger and the Cage tells a story that transcends Bolden’s individual experiences. Throughout the book’s 337 pages, Bolden transports readers on a journey: from the pain and shame accompanying her first menarche; to the sterile offices of innumerable doctors and surgeons; to the author’s dorm room as she struggles to disentangle her sexual identity from her chronic pelvic pain; to the scientific findings of the first doctor to discover endometrial overgrowth in the bellies of rats in 1860; to the 19th century halls of Paris’ Salpêtrière hospital, where female patients labeled “hysteric” were confined and subjected to experimental psychiatric treatments. With these braided narratives, Bolden’s personal experiences tap into deeper systemic issues as she comes into conversation with a lineage of women with shared pain and enters the trenches of a system blinded by doubt.  

Although much of The Tiger and the Cage underscores the loneliness that often accompanies endometriosis and chronic reproductive illness, the book leaves the readers at a rare moment of connectedness. After undergoing a botched hysterectomy at the age of 33 in an effort to abate her worsening symptoms, Bolden returns to her teaching job to pick up paperwork before the start of a new semester. While parsing through class materials in her department’s office, she breaks into a prolonged hot flash. Her immediate impulse is to shrink with embarrassment at the sweat dripping from her body onto the counter: “I looked down [at the sweat] in horror… a singularity of the shame my body carried around as it carried me around” (p. 324). Instead, she divulges a sliver of her endometriosis journey with the older administrative assistant, and the two women discover that they are bound by a shared bodily experience. “The day I had my had my hysterectomy,” the woman tells Bolden, “…[I] finally felt free” (p. 326) 

Although this is a moment of tenderness and reciprocity, it is also a stark reminder of the enduring pervasiveness of endometriosis. With this reminder, we are left to question: in a world where half the population has a uterus, why do women’s health issues remain so shrouded by shame and secrecy? In a society where 1 in 10 people with uteri suffer from endometriosis, why have we invested so little into understanding and treating the disease? What would it take, culturally, ideologically, and materially, to truly believe women’s experiences of pain? Through witty prose, thoughtful research, and harrowing personal narrative, Bolden forces readers to grapple with such questions while bearing witness to the same type of pain our system so frequently ignores.  

Sarah Cheshire is a writer, creative collaborator, and artist based in Tuscaloosa, Alabama. She is the author of two award-winning chapbooks: Unravelings (Etchings Press, 2017) and Scrolls for Blue Bottle Trees (forthcoming from Gold Line Press, 2026). She has had essays, poems, and reviews published in The Rumpus, Creative Nonfiction, Scalawag, River Teeth, Brevity, and The Journal of Compressed Creative Arts, among others. In 2018, she was awarded AWP’s Kurt Brown Prize for Creative Nonfiction and was a finalist for the Disquiet International Prize.  She currently teaches English at the University of Alabama.