As I recovered from labyrinthitis, I realized I didn’t want to write in code anymore.

In 2000, I worked for a few months as a student chaplain at a children’s hospital. I was enrolled in divinity school and planning to become an Episcopal minister, but my time at the hospital disavowed me of those plans. I couldn’t handle the devastation I saw there. I still can’t handle it. Instead of going to divinity school, I moved to Chicago and worked as a typist for temp agencies until eventually landing a job doing data entry for Booklist magazine, a biweekly book review journal.

A few months later, I got my first chance to review a book after an editor asked me if I liked romance novels. I told her I loved them, and she gave me a novel set in seventeenth-century London. Over the next five years, I reviewed hundreds of books for Booklist—from picture books about the Buddha to poetry collections—and in the process, I became fascinated by the format of the review. Booklist reviews were limited to 175 words, which meant each sentence must work multiple jobs. Every review had to introduce a book while also analyzing it. Your compliments needed to live right alongside your concerns.

At Booklist, reviews do not include ratings on a five-star scale. Why would they? In 175 words, one can communicate far more to potential readers than any single data point ever could. The five-star scale has only been used in critical analysis for the past few decades. While it was occasionally applied to film criticism as early as the 1950s, the five-star scale wasn’t used to rate hotels until 1979, and it wasn’t widely used to rate books until Amazon introduced user reviews.

The five-star scale doesn’t really exist for humans; it exists for data aggregation systems, which is why it did not become standard until the internet era. Making conclusions about a book’s quality from a 175-word review is hard work for artificial intelligences, whereas star ratings are ideal for them.

It’s tempting to make labyrinthitis a metaphor: My life lacked balance and so I was devastated by a balance disorder. I spent a month drawing a straight line of a trail only to be told that life is never simple paths—only dizzying labyrinths folding in on themselves. Even now I’m structuring this introduction like a maze, coming back to places I thought I’d left.

But this symbolization of disease is exactly what I’ve tried to write against in my novels Turtles All the Way Down and The Fault in Our Stars, where I hope at least OCD and cancer are portrayed not as battles to be won or as symbolic manifestations of character flaws or whatever, but as illnesses to be lived with as well as one can. I did not get labyrinthitis because the universe wanted to teach me a lesson about balance. So I tried to live with it as well as I could. Within six weeks, I was mostly better, but I still experience bouts of vertigo, and they are terrifying. I know now with a viscerality I didn’t before that consciousness is temporary and precarious. It’s not a metaphor to say that human life is a balancing act.