In the summer of 2013, Andrea Kottow, 51, learned of her father’s first fall. Miguel Kottow Lang — a renowned ophthalmologist, academic and bioethics specialist — had been perched on a chair, trying to repair a curtain in the house he shared with Andrea’s mother, when he lost his balance and fell. The fall changed many things, though not immediately. At first, it was just broken ribs, which Miguel silently managed with medication. However, after his mobility difficulties and other symptoms became apparent, the diagnosis came: he had Guillain-Barré syndrome, a rare autoimmune disease that causes the body to produce antibodies against its own tissues.

The illness “changed my father forever,” notes the Chilean academic, who teaches at Adolfo Ibáñez University in Santiago: she did her undergraduate studies in Hispanic Literature at the University of Chile and completed a doctorate in the History of Medicine at the Free University of Berlin. The self-reliant and protective figure she had always known suddenly transformed into a fragile and vulnerable being, who nevertheless managed to complete a book about his experience: El Pa(De)Ciente (2014). This memoir, in turn, inspired the 2021 Spanish-language film of the same name (released in English as (Im)Patient), in which Miguel and Andrea are played by Chilean actors Héctor Noguera and Emilia Noguera, also father and daughter.

The book portrays the predicament of a doctor who is suddenly on the opposite side of a medical system that he harshly criticizes. But it is also – as his daughter would reproach him – a work written by a man who appears to be “alone, without a family.” She “couldn’t believe that all the suffering felt and all the efforts made by those of us around him” were merely a peripheral matter. It was his version of events – he was well within his rights – but she still found the book to be “painful and incomprehensible.”

It was then that, upon seeing her reaction, Kottow Lang told her: “This is how I experienced it. If you want your [experience] to exist, you’ll have to write it yourself.”

And so, she ended up doing just that (although, she clarifies, she didn’t write her own story because she felt provoked by her father). This past April, the author of Spanish-language works translated as Frontiers of the Real (2022) and Diseases of Modernity (2022), among other titles, published Truth Also Moves: An Essay on Literature and Fatherhood (2026). This is an unusual work, where the essay genre allows for the merging of intimate chronicle, self-examination, family genealogy, as well as a look at literature and film, in order to understand father-child relationships. The book has moved both readers and critics: in EL PAÍS, Chilean literary scholar Joaquín Castillo declared it to be “brilliant,” containing “enormous reflective depth.”

In a conversation with this newspaper in the study-library of her home – located in the northeastern Santiago borough of Ñuñoa, Andrea Kottow comments on some aspects of her latest work.

Caring for those who cared for you

“The most dramatic thing – one that’s already become a cliché – is the reversal of roles,” the essayist comments. Her words flow effortlessly, occasionally revealing a hint of an accent from her time spent in Germany between the ages of four and 13: “With the aging of our parents – their illnesses, their decline, their need for care – we begin to become, in part, ‘the caregiver of the person who once cared for us.’ One could think of this as a kind of cosmic justice: it’s my turn to give back what I was given. And it’s also somewhat about the elderly becoming like children again.” And that’s how, in caring for the elderly, “a lot of our own contradictions and limitations come to the fore.”

Now that elder care is gaining prominence in public discourse, the decline of our own parents becomes an unavoidable issue: it can be the origin of moral, ethical, financial and mental issues that are experienced with varying degrees of intensity. In the case of Andrea Kottow — whose father, now 86, is still able to care for her 90-year-old mother — a critical turning point was the end of his autonomy in 2013, after his fall.

As she recounts in her book, after describing an incident in which she had to help him urinate because he was unable to do so himself, Miguel Kottow became “terrified at the thought of becoming someone who couldn’t take care of himself.” Meanwhile, his daughter recalls, Kottow’s close circle was dealing with the flip side of this predicament.

“There’s a lot of confusion among people who experience their parents aging,” she adds. She explains that there isn’t just a feeling of guilt: quarrels can also emerge among siblings. “Who takes on more responsibility? Who has what role? Why does the other [brother or sister] live so far away? Why can’t one of them make it to [their parents’ place]? How do we divide up shifts?”

Therein lies “an issue that we’ve barely resolved,” she reflects. “We live in an aging society, where life expectancy is increasing dramatically and where tertiary care is extremely expensive. And we don’t know if it’s our responsibility; we weren’t warned that it would be. In older societies, it was obvious that children would take care of their elderly relatives. But we don’t really live that way [today]: we live more with the idea that everyone is independent and has their own life. But suddenly, we’re faced with this problem: [when] should we intervene in someone else’s autonomy? Does the other person want this? To what extent do they allow it? To what extent can someone tell their parents, ‘Don’t do this [activity] anymore, but I have nothing to offer you in return’? What am I offering them in exchange for taking something away from them? What right do I have to take something away from them? I don’t want them to go to the beach by car anymore… but I can’t take them there myself either.”

Having elderly parents “is an experience that we’re all having… and it’s one that I was very interested in reflecting on,” she concludes. However, she understands that the book – written several years after the events it describes, reflects “the perspective of someone who is aging and is much more aware of their own mortality.”

When it came to writing, the themes multiplied: on top of the musings about old age, she needed to add some thoughts about death, or how we’re connected to our mother as the body that gave us life and nourished us, as well as to our father as “the person who gives us our surname, our sense of belonging to a family and the rule of law that either permits or prohibits.” That father whose authority – in Andrea Kottow’s case – suddenly faded away.

The author says that she feels suspicious about “this whole autobiographical [style], which has been so studied and celebrated, as if now everyone has to write about their own life.” That’s why, she continues, she needed “to find the tone of a self that I could empathize with; not so much [writing] from the affective empathy of, ‘oh, poor me,’ but rather [creating] a platform for thinking about the ‘I’ in the collective sense.”

So, what kind of “self” does she describe? It’s one where every reader can say, “‘I also have a father, I also have a mother – or I’ve had them – and I’m also part of a family system. I’ve also thought about what kind of inheritance comes from being part of a family.’ That writing of the self was, for me, the most delicate kind.”

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