Wednesday, June 18, 2014

Cancer: the last obscenity

My third Good Letters post for the Image Journal is up this morning. It is a reflection on living with terminal cancer, as I have for the past six-and-a-half years. The theme of the post is also the theme of my book in progress, Life on Planet Cancer. My oncologist tells me that most patients collapse upon being being diagnosed, sinking into resignation and despair, but while I have discovered small goodness in cancer, I have learned to live with it—have learned that you can still have a life under its shadow.

Cancer redefines you forever; to live in denial, to pretend that you do not have the disease, is self-denial. You reject what you have become in favor of some fantasy image of yourself. If you were to do this with any of your other limitations, your height, your intelligence, your capacity for self-exertion, you would recognize it for the neurotic lie that it is. About cancer, though, our culture is forgiving: you are permitted the escape from responsibility you would not otherwise be permitted. And why? Because our culture no more wants to acknowledge the reality of cancer than those with the illness. Cancer is, perhaps, the last obscenity.

Anything, please, but the reality of cancer! The culture celebrates “survivors” who have triumphed over it, praises the dead for having “fought” it, but those who are living with the illness are invisible, hidden away. The culture will stoop to speaking the name of cancer, that is, only when it is past—not when it is a present reality for anyone.

When the baseball Hall-of-Famer Tony Gwynn died on Monday from salivary gland cancer, he was celebrated for his achievements on the field and off—rightly so—but his five-year experience of living with cancer was reduced to a “battle” and nothing more. How the disease affected his thinking, his coaching at San Diego State University, his self-image, his personal relationships, his faith—none of this was mentioned, let alone explored. He became a hero only in death, because his life while diseased is no one’s business, just as a person’s sex life used to be.


Unknown said...

Thank you for sharing such important thoughts. Let me paraphrase someone by saying . . . Living is the best revenge . . . You have given me so much to ponder in my own smaller challenges. Again, from your redneck Riviera friend, thank you.

Anonymous said...

Yet another thoughtful, and to me, valuable post. Thank you. My sweet wife lost her 'battle' almost seven years ago, but she seemed to understand the 'living' part better than most, including a sister, a doctor. Those last months with her, thanks to her and her desire to live every hour of every day to the fullest, were a true blessing, and some of our best times together. The end is fact, whether from cancer or otherwise, but savoring what remains, is priceless.

Rand Careaga said...

My college sweetheart V, she of the “spirited disagreement with cancer,” died early in 2008. Between the onset of her terminal illness eighteen months earlier and her death, she remained resolutely optimistic. I saw her but seldom during this period—it was a chore to penetrate the cordon sanitaire (or perhaps serviette hygiénique) of fiercely protective Sapphists who looked after her round the clock—and on each of these infrequent interviews it seemed clear to me that her health and overall vigor had declined since our last meeting. As I walked with her along a hospital corridor (she advancing her drip bottle along its stand step-by-step), she volunteered that while cancer was a drag, she’d at least got a handicapped placard out of it, permitting her free parking. “But I’ll have to give it back in two years.” “No you won’t,” thought I, but said nothing: I’d been warned that any discussion on my part about her prognosis would result in eternal banishment.

She had a dedicated team of oncologists, fierce as terriers, who advanced one experimental treatment after another, and she sailed through these right up until she and the medics ran aground. I saw her for the last time a week before her death, as UCSF discharged her. She was a little stunned, a bit more dismayed, finally resigned. “I really thought I’d get through this,” she whispered.

According to the accounts that reached me, she spent her last week being driven around the coastal highway in the vicinity of her home near Mendocino, and when not in the car she sat in a chair with a view of the ocean. On the eve of her death she was lowered into her favorite chair. “It’s tonight,” she said. Fell asleep before midnight; breathing gradually slowed, died before sunrise.

Was she in denial, do you think? I knew best the sunny, bold teenager, who flinched at little. I like to think that before the end she regarded the disease as one more obstacle to be surmounted, as she had effortlessly overcome so many before (for a UC humanities major she had a quite lucrative, wholly unrelated professional career), and that by the end she determined merely that with her life now measured in tens of hours, she would taste each one of these as vividly as she could.

In more-or-less sound health at 61, with, unlike you, a reasonable prospect of reaching 65, I can’t immediately relate to your situation, except that in our sixties we are all of us in the latter stages of a mortal condition with which we were infected at conception. You are being hastened forward to a destiny I might not reach for another eight years, if my mother is taken as a gauge, or for another thirty, if for my many black sins I am condemned to endure the decrepitude of my father, who retains at nearly 93 the wit to suffer the extreme physical debility that has overtaken him.

We’re all climbing the same mountain by one route or another. You’re scaling the summit. From these lower reaches I can only yodel my best wishes for a passage minimally arduous.

D. G. Myers said...

A very moving story, Rand. (Did I know V. at Santa Cruz?) You would have to know more about V.’s thinking in her last months to know whether she was living in denial. From what you say of her, though, I very much doubt it.

Yes, we are all dying. Perhaps the only real difference between me and you in that I know approximately when.

But there are other things about dying of cancer that I’d prefer not to speak of—at least not right now. The pain, the exhaustion, the eternal recurrence of chemotherapy, and for me the loss of mobility when cancer destroyed my right hip: these are “extras” to the delight of growing old.

Unknown said...

FYI . . . and because I want others to know about you . . .

Even though you and I have never met, and ever since your days at TA&M, when you and I corresponded, I have considered you a friend.

So, I have made the posting below at my blog. If you object to my posting, tell me and I will take it down.

Rand Careaga said...

You asked about V. She used to drop in on me during those two years at the College V dishroom (more frequently at Cowell, where I had the weekend gig), and you may have caught sight of her. A Russian beauty; a trifle zaftig in those years; lean as a greyhound by the latter Seventies and particularly following cancer first sampling her late in the XX century.

Picture here.

Do you remember "Isadora," who would send us cookies and treats down the conveyor belt? She is still among the living.

BPSilverman said...

The Mercy of Sickness before Death was so poignant. I hope to one day get my hands on the finished book that perfectly written essay will wind up in, as I long to hold on to every last word. I never believed in luck until I was diagnosed with cancer at age twenty six. Luck, I believe Cicero said, is when preparation meets opportunity (although I hear people credit Oprah with the quote these days). I wasn't prepared for cancer, but I most certainly welcomed the opportunity to live fully. My eyes are open so wide, these days I find myself frightful of sleeping; for every extra hour spent in slumber is an hour I am disconnected to all that lives and breathes. Clearly this lack of sleep does not jive with my cognitive impairments or physical well being, but I have convinced my friends that I've taught myself to sleep effectively; that the chemo and mono-clonal antibodies and anesthesia from ten procedures left me bionic. Instead of challenging me or telling me otherwise, they stopped calling me Beth and started calling me Bethonic (it seems I've found plenty of the friends of whom you speak). Of the 64 friends I have buried to this beautifully tragic disease, I am reminded with each and every passing that life is for the living. So I press on in my travels through cancer land. Some days it rains here. But then, of course, I get to see rainbows.