31 July, 2020
‘Cancer messed with the wrong bitch’ is an actual phrase printed on real t-shirts. ‘You got this’ is something people say to acquaintances who announce their diagnoses on Instagram. Both slogans intend to cast the sick person as the victor of a battle, but the battle doesn’t really exist. Moreover, as toneless words on a page, ‘you got this’ can signify the fact that one has cancer, and that cancer messing with the wrong woman might mean she will die quickly—prematurely taking the tumours down with her. When Steve Jobs was first diagnosed with pancreatic cancer, so says Wikipedia, he believed he could somehow control the disease himself and delayed chemotherapy treatment to take up meditation and juicing. Meanwhile, Belle Gibson, an Australian cancer blogger duped thousands of people into believing she cured her brain cancer with food, and momentarily made a living from the lie.
Different versions of all these fictions are published in books, on blogs and Instagram hashtags. And, like cancer, these ideas are ubiquitous. While it is easy to dismiss them as false hope, hubris or nonsense, they all are in different ways a logical manifestation of the desire to live intersecting with pervasive contemporary myths about the power of the individual. They are also no doubt responding to the legitimate fear caused by cancer diagnosis and treatment, which is underpinned by a desire not to suffer. Anne Boyer’s memoir, The Undying: A Meditation on Modern Illness (2019), reveals that in this instance cancer kind of does mess with the wrong person, but for very different and quite particular reasons.
The Undying details how the specific kind of suffering caused by cancer—the same feeling the people wearing the aforementioned t-shirts are trying to avoid—is located not as an innate property of cancer, but in relation to almost everything else. ‘For any author of doing the dishes,’ writes Boyer, ‘the best part of the story would be the story of missing out on everything else while the dishes are being done.’1 The suffering involved in cancer under capitalism is compared in this text to being sick and having to do the dishes at the same time. All that is needed to end the suffering is someone else to do the dishes, but this is easier said than done.
In all of it, though, the only difference between her own sense of suffering and anyone elses’ is her wherewithal, despite enduring apocalyptic chemotherapy, to write about the experience:
If you didn’t know me, writes Boyer, you might think…that my illness was so precious it was merely a suffering for the sake of semiotics, that I sat in the infusion room thinking only of Ancient Rome. But I was a single mother without savings who existed in a world of profit, had no partner to care for me or family nearby in a world that privatises survival, had to work all through my treatment at a job where I was advised never to let on I was ill, had never had wealth or been proximate to the seats of power. In other words, my cancer, like almost anyone elses’ was ordinary, as was, apart from my practice of writing, my life…My cancer was a captive fear that I would die and leave my daughter in a hard world with no resources…a terror that all I’d ever written would sit data-mined but not read on Google’s Servers…and in the meantime, I would become that unspeaking thing, a dead person, leaving too soon who and what I loved the most behind, unprotected, and alone.
Her suffering is not an innate property of cancer but in the way she’s been told to live her life—in the academic precariat, single and parenting while pretending to be rich, successful, powerful and strong. The performance of power can only get one so far in a mortal body. The clarity Boyer attains during cancer treatment thus enables the stark representation of a shocking revelation. The revelation of the extent to which the lie of human individualism literally structures everything in contemporary America. It is not just an aspiration or idea, but a material reality baked into their institutions and their selves, even when an individual body desperately wants to live in common. Everything from the economy, the university and the medical system, to the contemporary socialist feminist poet’s career, identity and emotional life is structured by this particular lie. The memoir documents the suffering instituted not by nature, or cancer, but by the falsehood of individuality. Thus, in this memoir the poet is compelled to write through the lie of individualism in a new way.
Boyer was evidently aware of the ruse of the individualism already, Garments Against Women (2015) is about this too, but in cancer this problem is completely and utterly embodied from head to gut to toe: it is sensed in the range of negative emotions that the illness causes (fear, panic, despair, anxiety, anger, rage et. al.) and in pain, nausea and loss (of breasts, taste, smell, hair, toenails, the contents of one’s stomach). As Boyer writes, ‘We have physical bodies…All of these bodies—ours and everyone else’s—is adhered to decay…The ordinary ongoingness of our existence, like every time we do the dishes, is every time we try to block ruin’s path.’2 Boyer’s text works to demystify the suffering and make this connection between a suffering cancer patient and capital both absolutely real and completely unnecessary: ‘Cancer is held apart as a very special kind of suffering but suffering from the inevitability of our common accident isn’t valiant.’3 In other words, this suffering should not exist because cancer is actually just a particular way of dying.
But this valorised suffering does exist and Boyer’s memoir writes through her experience of this suffering, giving us a new way of understanding it. Ultimately, the suffering is not caused by cancer, it is caused by capitalism’s contempt for the unprofitability of care. Capitalists loathe doing dishes.
Apprehending the novel epidemiology of her suffering does not make a cure for either cancer or capitalism any more likely, but I wonder if it brings us a step closer to it all the same. All the breast cancer memoirs I’ve read wrestle with the acute individual suffering catalysed by diagnosis and treatment. I’ve read a lot of them because cancer also messed with this bitch (so to speak) and when it did I found solace in reading about other people experiencing the same kind of trauma. The difference between a good cancer memoir and, say, Steve Jobs’ turn to juicing, is not related to the intensity of anyone’s desire to live. The desire to live seems similar across the board. The difference is in the extent which a sick individual believes they can control the outcome. The former surrenders at least some of that control before they start writing, while the latter holds on to control for as long as possible.
In the breast cancer memoirs I read, though, surrendering control did not equate to placing apolitical faith in the medical system. To the contrary, surrendering a sense of individual control over cancer’s telos within an individual body seemed the most direct pathway to embodied politics.
So, while wrestling with the individual desire to live in the face of a potentially terminal diagnosis is a trope of the breast cancer memoir genre, the texts all differently locate the individual with cancer in relation to society, history, politics and the economy. Is the individual with cancer submerged in a broader context or is it a story about an individual’s experience of that context? Susan Sontag’s Illness as Metaphor (1978) is so depersonalised and focussed on the history of illness and its representation of illness, it passes only as ‘memoir’ because she was famous enough that we know she wrote it after breast cancer diagnosis and treatment. S. Lochlann Jain’s Malignant: How Cancer Becomes Us (2013) is a sociological study about the cancer-industrial complex, but the various lines of inquiry stem from a ‘curl of feeling’ they had during their treatment. Audre Lorde’s The Cancer Journals (1980) explores the radical potential of feelings during cancer diagnosis and treatment to provide new information about ways of resisting oppression and creating spaces for black, lesbian, feminist lovers and poets. Eve Kosofsky Sedgwick’s A Dialogue on Love (1999) models a queer therapeutic process via an intensely personal recount of her years in psychotherapy with Shannon, in which the ‘triggering event’ that sends her to therapy in the first place is a breast cancer diagnosis.4
If there were a spectrum along which Sontag’s is placed as the least personal of the good breast cancer memoirs and Sedgwick’s as the most, The Undying is the whole spectrum all at once. In Sontag, the metaphors for illness across history are revealed as bearing no relationship to the actual experience of illness: the metaphors of illness are a great ruse. In Sedgwick, the psychotherapy process relayed in the book is the personal reckoning catalysed by cancer—ideas of illness, and the treatment itself, are referred to very little. Boyer’s text, in contrast, represents what it personally feels like to be treated in the depersonalised for-profit American health system.
Interview-averse Boyer spoke at length about the book’s form on the Commonplace podcast. She described her goal to make the process widely readable. She described surrendering to various editors in order to achieve that goal.
The book’s readability, despite its poetry, is thus a political act. To say it is readable is not to diminish the book’s achievement. It is to say that the book makes sense if read as an emotional relationship with a big structure and a single life; as a study in the cruel symbiosis between a system that is keeping you alive while trying to kill you while trying to save you.
The individual, Anne Boyer, is an inferno of human emotion diagnosed with the deadliest kind of breast cancer at this point in history and subjected to an entirely brutal regime of chemotherapy and surgical treatment, and quite literally kicked out the door at the end of each day: ‘In the large and bustling space in which my cancer treatment is administered, I’ve never seen a bed.’5 In this text, Boyer’s embodied and affective experience of suffering cancer is given equal weight to the cancer-industrial complex as it interminably unfolds in earth history. The point she makes over and over again in a variety of ways, though, is that her particular suffering should not exist: after her mastectomy surgery she should, in other words, have been given pain medication and a bed but, she says instead ‘they made me leave. And I left.’6 The problem here is not that the treatment is life-alteringly toxic, because right now this is the only available treatment that will save her life. Her point is that the system is willing to cut her open and poison her to save her life, but not even give her a sink to throw up in afterwards.
It is impossible to read this text now without also thinking about COVID-19 and the differences between America and Australia. Cancer treatment here isn’t a walk in the park—it never is—but after my surgeries I had a bed for several weeks—for free—with meals and nurses. The suffering Boyer endures seems remote; it’s a warning about how bad things can be. During COVID-19, I’ve been thinking and rethinking and learning anew the fantasy of individualism and human exceptionalism. We all have. We are all acutely conscious of the way we share bodily fluids on a daily basis with complete strangers who we never even touch. In Australia, decades of retreat from government support for health and employment have had to be, at least temporarily, restored to deal with this crisis, just as we watch America abandon its people at a staggering scale.
Reading The Undying once just before, and twice during COVID-19, I realised something about cancer that is perhaps obvious but made more so when set against the apparent virulence of COVID-19’s contagiousness: cancer reveals the fantasies of the individuated human body in particular ways. Consider COVID-19 clusters in relation to cancer clusters. While in the former two weeks after a wedding or a funeral all the people are sick, while in the latter two decades later maybe exposure becomes disease. As Boyer observes, ‘talk of shared environmental etiologies is condemned as paranoid, but the loneliness of genetic fatalism runs rampant.’7 The link between people and place can only be found if the community still miraculously coheres enough to make any links between place, proximity and people still visible, and even then the burden of proof is extraordinarily high because of the temporal lag between exposure and disease. Thus the experience of cancer is as a ‘disease of probability, rather than communicability…that we catch our disease from the shared world absolves us of the fear of giving it to one another directly.’8 Despite its sluggish ecological temporality, to think of cancer as a collective and eco-social disease requires a new vision for our shared world; cancer is a disease that is communicable but on a different time scale and in relation to different kinds of contagion. In this analogy, if COVID-19 is a storm, cancer is climate change.
As I said above, Boyer locates the suffering involved in a cancer diagnosis not within cancer but within the way it heaps suffering on the body of the sick because of capitalism. Boyer wonders if the form of collective experience of suffering: ‘…if even half of us who were sick at the same time felt the desolation of our treatment, could this vast and common loneliness be anything other than evidence that we have been fooled?’9 The implications of this question are staggering when considered in light of the imperative to be positive—both the sick and their beloved—in the wake of a cancer diagnosis. At the same time, is she maybe just asking everyone to do their share of the dishes?
Anne Boyer, THE UNDYING (2019)
Pain, vulnerability, mortality, medicine, art, time, dreams, data, exhaustion, cancer, and care
Published by Farrar, Straus and Giroux