Tuesday, April 05, 2011

Diagnosed with cancer

The biblical scholar James L. Kugel has written a new book on life in the shadow of death. Diagnosed with cancer ten years ago, Kugel doggedly finished The God of Old, a study of the religious experience (as Jack Miles put it) “before the time when God came to seem omniscient and omnipresent,” and only then did he set to work on In the Valley of the Shadow, published in February by the Free Press.

The diagnosis of cancer sent Kugel on a “quest for the foundations of religious belief,” writes Eve Levavi Feinstein at Jewish Ideas Daily. “While Kugel’s previous books focused on Jewish and Christian traditions, In the Valley of the Shadow deals with basic, universal questions and seeks answers wherever they may lie”—including in neuroscience and evolutionary biology.

Still, Kugel ends up preferring the God of old. Modern man now has, as Feinstein says in summarizing his views, “so much stronger a sense of power and agency,” which may explain “why true religious experience is so rare today.” Or, as Kugel himself says, “man is very big, and God is very far away.”

The God of the Hebrew Bible, whom Adam and Eve hear moving about the garden, with whom Abraham argues and Jacob wrestles, who permits Moses a glimpse of his backside, could be near at hand for the cancer patient, if somehow he cover recover the ancient belief. As Kugel says on the last page of The God of Old, written in the full awareness of his cancer, “[A]ncient Israel somehow came to believe that it is simply God’s nature to hear the victim’s cry, that despite all the evidence to the contrary and despite all common sense, this was, in Israel’s view, a realistic portrayal of God’s essential nature.”

How surprising to learn from Feinstein, then, that Kugel believes the “sickening question” asked by most cancer patients (How could this happen?) is not the right question. For Kugel the right question is some variation of Who said life is fair? On his own evidence, God said life is fair. It is modern man, a stranger to God’s closeness, who confidently rejects any notion of life’s fairness—until he is diagnosed with cancer.

For someone like myself, though, living for the past three-and-a-half years under the shadow of a Stage IV cancer diagnosis, neither question is right. Both of Kugel’s questions are “sickening.” The first is an expression of self-pity, which may be forgivable as an immediate reaction to overwhelming knowledge, but which shades over into denial the longer it is asked. The second question is a denial of another kind: it denies that there is any pity—any fairness—in the universe.

Both questions, it seems to me, are attempts to ask the meaning of cancer. But cancer is not a text to be interpreted or puzzling behavior to be understood in context. It is an organic process to which the human body reacts as an organism. This is why I am irritated when I am told to “fight” my cancer. Perhaps the drugs which are administered to me can be said to “fight” the cancer. At best I am ringside at the fight.

As an organism, I react to cancer in ways that I am unable to control. As a person, though, I respond to it—and not to an organic process, but to a human drama. My response is entirely within my control. I can elect self-pity or a universe without pity or take an altogether different stance. The right question, then, is How am I going to respond?

A diagnosis of cancer is a life-changing event, and the only question is what changes to make. In his new book, Kugel describes the change movingly:

[T]he main change in my state of mind was that the background music had suddenly stopped—the music of daily life that's constantly going, the music of infinite time and possibilities. Now suddenly it was gone, replaced by nothing, just silence. There you are, one little person, sitting in the late summer sun, with only a few things left to do.My own change was not nearly so moving. I remember that I was sitting in the back of the house, rocking slowly in the chair that my wife and I had purchased five years earlier for her to sit in comfortably while she nursed our newborn twins, and I was feeling profoundly sorry for myself. I was struggling without success to read some hefty book. Chemotherapy had left me with “chemo brain,” a state of mind in which everything was fuzzy and no idea ever wandered. “I can’t think any more,” I moaned softly to myself; “I can’t think any more.” Suddenly I stopped rocking. “Wait a minute,” I said; “that’s a thought.”

From then on I decided that, if I could no longer think as well as I once did, I could still direct streams of thought over the objects I chose. If I could no longer roughhouse with my boys as roughly as I once did, I could still roughhouse with them. If I could no longer be married to my wife “forever,” as I once promised, I could still be married to her for as long or short a time as remained to me.

The error that so many commit, upon hearing a diagnosis of cancer, is this. Cancer is not the concluding sentence, but a revision in a work that remains unfinished.


Fabio said...

"A diagnosis of cancer is a life-changing event, and the only question is what changes to make."

This is a crucial question -- for everyone, I think, even those who haven't been diagnosed with cancer. Can we ourselves decide "what changes to make", though? What does it take to go through a transformation that goes beyond mere superficiality? We read so many books, we get married and have kids and go to work and maybe even become "religious". But do we really change? What kind of Experience does it take, to change with profundity, if even the threat of death doesn't seem to do it?

My father, already in advanced stages of emphysema, and knowing full well his own father had died of this same disease, refused to heed the doctor's order and continued smoking, saying to himself he had no problem with dying. He only quit a couple of years back when a greater fear was struck into his heart as he heard the physician say to him: "the problem here is not dying, but having a stroke or worse -- and then your wife will have to take care of a living vegetable."

I am thus reminded of a phrase of George Bernanos' (my translation): "We ought to know that the threat that weighs upon us all is not only of dying, but of dying like imbeciles". ("Il faut que nous sachions bien que la menace pesant sur nous tous n'est pas seulement de mourir, c'est de mourir comme des imbéciles”.)

AJ said...

This is why I am irritated when I am told to “fight” my cancer. Perhaps the drugs which are administered to me can be said to “fight” the cancer. At best I am ringside at the fight.

It seems that professionals, and not the medical kind, like to encourage one "fight" cancer or any other serious disease. It comes from their earning psychosis: everything they have in life, they've earned, including their good health. If you're sick, boy, that's like being poor--you've let something slide, you've stopped doing the work. Don't be poor, and don't be sick, if you want to have their friendship. Why bother? Just tell them that you're not friends with robots but only with human beings. They will huff and puff and the "implication," but in the end they will just fall away. The true friend stands by you, even when you're homeless. Of course, such friendship is seen as maudlin and perhaps crazy by the professional class.

D. G. Myers said...


Let me put it somewhat differently, then. Cancer reduces you to necessity of making changes. These do not necessarily include giving up your life-threatening bad habits. To keep them up, in the face of terminal illness, is itself a change. Their significance is now different.


D. G. Myers said...


I could not disagree more. Of course, my wife is a physician.

Nor did my oncologist—a genius and a mentsh—ever tell me to “fight” the disease or imply that I was somehow the “poorer” for it. What he reminded me, regularly, wss that there is a wide difference between the textbook course of a disease and the way it actually works itself out in an individual person’s life.


Interpolations said...

Thank you, a wonderful post. Thank you. Cheers, Kevin

Harald Striepe said...

Clearly, everyone dealing with it has to make individual choices. In my personal experience, there were two parallel battles, tightly linked.
In the physical battle of surgery and chemo, I could help determine strategy, but I was a passenger dealing with the day to day outcomes. But my mental battle had a decisive impact on everything.
To me, it held on to the dignity of being human, continue the fight without drowning in everything, and with that, create lasting meaning for me. The battle truly was one to fight for life through physical means like maintaining exercise despite significant pain and physical discomfort, and the mental effort to move out of depression and the passivity it creates, the will just to let go.
It was crystalized for me one night in the oncology ward after a serious crisis 4 nights before, when my Dr.s fought for my physical survival through 6 hours of crises before i stabilized. In recovery, I felt very week and ill, and without dignity - tubes, every orifice monitored, and the inability to clean myself properly or do anything without help. I was not doing well, and I realized I had the choice to let go, and leave all the suffering behind, or to truly keep fighting and get out.
I chose life. It was another four months of struggle.
But two years later, it is but a memory that I have to hold on to to remember and cherish!
I truly believe that that kind of choice matters and impacts the outcome. To me, cancer truly was a battle for life, the hardest one I ever fought.

Marly Youmans said...

An interesting post and comments, too--would be interesting to look at fiction and cancer and where they intersect as vehicles of estrangement from the ordinary and as catalysts of change.