Swimming Upside Down

Winner of the 2025 Sarabande Prize in the Essay, selected by Leslie Jamison

Swimming Upside Down by the late Karen Kao, a writer Maggie Nelson described “swerves with grace,” is a sharp-edged and sober account of a life deeply lived

In her posthumous publication, Swimming Upside Down by Karen Kao is about a woman, who becomes a patient who must come to terms with her terminal diagnosis and the fact that “She won’t be a patient forever.” With unflinching honesty Kao reflects on the people, events, and moments that have shaped her life. It is about joy and disappointment, anger, sex and desire. It’s about the mistakes we make and the love that we should never let go of. Her essay, “Fish Tales” included in this collection was selected by Maggie Nelson to win the 2022 Kenyon Review Short Nonfiction Contest. Nelson described the essay as having “great rhythm and propulsion. It’s pretty then gross then sad then worrying then exciting. It slips in and out of weird synecdoche, swerves with grace between divergent forms of address. It treads on cultural fault lines, familial discord, sensory experience, the move from childhood to adulthood, without wasting time explaining. I’d read a book of it.” Finally, here is that book.

Kao’s bawdy humor is reminiscent of the late Carrie Fisher, her insight and observations of life, illness, and death mirror Suleika Jaouad’s Between Two Kingdoms and contains the tenderness of When Breath Becomes Air by Paul Kalanithi. Swimming Upside Down is a humbling, raucous, deep and tender, outrageous and fierce declaration of life.