Cancer Gadfly: Still Alive, or The Mortifications of Survival

Readers of the London Review of Books will know that Jenny Diski has been writing diary posts about her cancer for over a year. In “Who’ll be last?” (November 19, 2015), Diski reflects on the embarrassing situation of those of us who announce our forthcoming death from cancer, yet still remain alive to write about it. She cites the case of Clive James who “after telling the world five years ago that he had untreatable leukaemia, has had to apologise for not yet being dead.” And offers a quiz show challenge: “Which writer lived the longest and wrote the most columns and/or books after the announcement?” On the other hand, if cancer “were a race, the first man home…would be Oliver Sacks (announced 19 February―died 30 August.” In this race, you win by dying, quickly.

Diski is tough on the subject of cancer. To say she is unsentimental about her illness is to understate the wicked violence of her prose. She delivers details about the treatments she endures in a tone that wards off sympathy, while shocking the reader into the realpolitik of surviving with cancer thanks to innovations in modern medicine.

I enjoy reading these irascible manifestos, hard to know what to call the genre–rant, screed, complaint―writing that bears witness to the kind of suffering we’d all prefer to avoid, honest testimony, without cheerful sanitizing, more rare than you’d think. (Susan Guar’s Memoir of a Debunked Woman, Jochlann Lain’s Malignant, and Miriam Engelberg’s Cancer Made me a Shallower Person―sadly, Engelberg died the year her memoir appeared–are brilliant exceptions to the rule.)

Most of all, what I liked about this installment is the limning of the embarrassment of remaining alive, outliving the statistics, off the charts, fill in the cliché.

This embarrassment weighs heavily on my mind because soon I will have another scan. I’m not sure which number this is, somewhere in the double digits. Except for the diagnostic scan in December 2011, and a serious scare one year into treatment that led to a biopsy, the scans have been consistently “good.” More recently, since I’m on chemo break, the oncologist calls them “stable.” As an acquaintance in treatment now for her lung cancer likes to say, “stable is the new good.”

Each time, though, I’m convinced the scan will be bad, and when it’s not I feel I should apologize to my friends for having worried them. If dying is winning, I’m still losing, but it’s not the kind of race where you really want to finish first.

Cancer Gadfly: My Envyometer

There’s lots of writing about cancer―memoirs, graphic and prose, blogs, narratological and anthropological studies, science reporting. Most of the writing is bad, by which I mean overly cheerful about outcomes, dull and cliché-ridden (my pet peeves), but in some cases my envyometer starts going wild: Oh this is so good (true to my experience, dark and savage), I wish I had written it myself.

In the category of recent fabulous cancer writers and cartoonists: Miriam Engelberg, Cancer Made Me a Shallower Person; Susan Gubar, Memoir of a De-bulked Woman (and her columns in the New York Times); Lochlann Jain, Malignant; Eve Kosofsky Sedgwick, Dialogue on Love (and her essays and columns in Mamm). There are other superb memoirs but I’m not looking to create a bibliography. These are twenty-first century texts (except for Eve’s in 1999), and cancerography is changing along with the new drugs―in particular, targeted therapy and immunotherapy. Writer Jenny Diski is publishing her memoir now by installment in the London Review of Books.

waiting roomEDITsmallNaturally, some things about the illness don’t change. One of them is the waiting room. My friend Jay Prosser, living in England, sends me clippings of Diski’s memoir as it appears. I don’t have a subscription to the LRB, and so I’m dependent on Jay’s excellent clipping service. The memoir seems mainly focused on Diski’s cancer―very much like mine, late-stage lung―and her grouchy persona inspires me to increased bitterness. Unfortunately, even with comparable staging, so many variations within a given cancer exist that it’s rare to find someone having exactly the same treatment. Diski, for example, has undergone radiation and I haven’t (yet). Still, I recognize myself in her weariness and fatigue, impatience with being a patient.

Sometimes the most dispiriting aspect of cancer treatment is time spent in the oncology waiting room. Diski’s seems more depressing than mine―at hers you have to wait for your number to be called―like the line at the fish counter at Zabar’s (my analogy, not hers). But in key ways, the experience is overwhelmingly similar. Here’s a passage from her February 5, 2005 installment in which Diski describes the setting where she watches for her number.

You began to recognize faces and played the new guessing game: which one has the cancer? It wasn’t always easy to tell. What was clear was the distinction between those of us who were having ‘curative’ radiotherapy and those who weren’t long for the world and were having it to help with pain management. Some of the latter arrived in beds pushed by porters, patients all of them grey of face and still, never looking about them at their surroundings. Others more mobile, came having been delivered by volunteer drivers and sat grimly with various wounds and scars from surgery, breathing heavily, none of them looking around at the other patients waiting. We―the less ill ones―stole glances at these patients, those on their last legs or whose legs no longer held them up. Even the most buoyant and cheery patient in the radiotherapy waiting room must have seen the mirror the bedridden held up for us.

And so the distinction, clear at the start, between those undergoing treatments that in theory will prolong life and those for whom the game is up, finally doesn’t hold. Unless you are very lucky―who knows, you might be―while you are there you can’t escape the prognosis that one day you will be waiting in the place of those beyond hope.