With a commission from the American Repertory Theater and its artistic director Diane Paulus, Eve Ensler adapted her harrowing, revelatory 2013 memoir In the Body of the World into an equally harrowing, revelatory play. I’d call it an unblinking work, but in truth I doubt anyone will come away from this evening without shedding some tears for its author and her subjects, which extend from herself to, as her title suggests, the malign and malignant inhabitants of our benighted planet.

Ensler is a ferocious advocate for women and other lost causes. Her interviews with the female of the species about their first time, worst time, cursed time, nursed time, burst time and even the odd best time resulted in The Vagina Monologues, an international sensation (probably only men would have called it “an unlikely international sensation”) that inspired the author to establish V Day, which turned Valentine’s Day into a day of protest and consciousness raising. Violence against women is her target; ending it, her passion. A survivor of childhood rape by her father, Ensler herself has never ventured far from the emotional and physical carnage she confronts. How she manages to create art from this is some kind of miracle.

But create art she does. In the Body of the World entwines two experiences, each of them uniquely public and private at the same time. In 2010, at 57, she is diagnosed with Stage 4 uterine cancer. Her work has taken her to Congo, where she has witnessed the unimaginable, unbearable rape, mutilation, torture and murder of females. Infants, toddlers, girls, young women, mothers, grandmothers: The rampaging soldiers on either side of the revolution don’t bother with distinctions.

I could recount some of the scenes Ensler observed and describes here, but I don’t think you would believe them. And if you do – she is not the only witness to such atrocities, as we saw in Lynn Nottage’s devastating play Ruined, to cite one other example – you will find it exceedingly hard to unsee them.

Joan Marcus

On a scarlet-drenched set (by Myung Hee Cho, exquisitely lit by Jen Schriever) at the Manhattan Theatre Club’s Stage One, Ensler, in all-black, establishes the two strands of her story right away: How she was estranged from her body at an early age and sought to reconnect with it through anorexia, drugs, promiscuity and eventually the activism that first took her to Congo and its women in 2007. Their dream was to create a healing village, a City of Joy, and Ensler was determined to make it happen. Just as City of Joy was about to open in 2010, she discovered the tumor and commenced her own odyssey through the maze of the Mayo Clinic (she is trenchantly funny about her treatment as “a guest at tumor town”) and Memorial Sloan Kettering (don’t ask).

Ensler is as unflinching in revealing the details of what she has lost in internal body parts, had reconstructed, or done without, as she is about what happened to the women of Congo. There’s urgency in the telling, but neither self-pity nor self-regard. Paulus (Waitress, Finding Neverland) has drawn an astonishing, and astonishingly anti-maudlin performance from Ensler. The clarity merely sharpens the attack on our senses, until we have gone with her through her own circles of Hell, which include childhood trauma, the ruinous consequences of being labeled “stupid,” the cancer gulag and, of course, being in the body of the world. Some of it is blessedly hilarious. Most of it isn’t.

Joan Marcus

And yet In the Body of the World is tough love, harsh medicine, a tonic. There’s light at the end, even a lovely reveal that embraces the audience without overdoing it or palliating what has come before. I came out rattled as I have rarely been rattled by any theater experience, devastated and blissful at the same improbable time.