When the door to Donald Hopper's garage rolled up, it revealed a scene out of Car and Driver. A mint, cherry-red convertible built in the mid-'60s was parked atop a gleaming black-and-white checkered floor — a giant racing flag. Hopper said it was the car cigarettes bought.
Several years earlier, he had quit smoking and saved what he would have spent on all those cartons of cigarettes. He used the money to buy the car — a car he spoke of as if it were a member of the family. I was there to write a story about a clinical trial he was participating in to keep his bladder cancer at bay. But somehow the study didn't seem nearly as important as Hopper, a man in his 70s, told me all about the car and then from there segued into memories about his wife, who had died a few years earlier of cancer. It didn't seem fair, he told me. Even his cat had died of cancer.
Every year around now, cancer gets boiled down to shorthand: Think pink. Stand Up 2 Cancer. Cancer sucks. Talking about cancer was once taboo, but those attitudes have fallen away, trampled by today's 13.7 million survivors and their family members demanding an end to the disease. And while the shorthand is probably necessary to further the cause, I always think of how it doesn't seem to do the Donald Hoppers of the world justice.
That's what literature is for. It gives shape and meaning to everyday details, to weddings and holiday dinners, to joy, to fear, to ambiguity. As cancer has become a more public disease, memoirs are proliferating. Several cancer centers even offer creative writing as a form of therapy to help patients and their families process what they're feeling and to document their lives. Cancer provokes questions that get at the very core of what it means to be human.
Perhaps one of the most incisive essays on cancer was published in 1981 in the New England Journal of Medicine. In "Of Dragons and Garden Peas: A Cancer Patient Talks to Doctors," author Calvin Trillin's wife, Alice, who lived for 25 years as a lung cancer survivor before dying in 2001, wrote:
"Cancer connects us to one another because having cancer is an embodiment of the existential paradox that we all experience: we feel that we are immortal, yet we know that we will die."
Earlier this year, I attended a talk by Siddhartha Mukherjee, author of "The Emperor of All Maladies: A Biography of Cancer," at Northwestern University. At a reception beforehand, a crowd of people clutched copies of the book. As they approached Mukherjee, their conversations followed a similar pattern: They heaped praise on the book, telling the author how they devoured it (all 500 pages) in a weekend, before they launched into their stories, their "testimonials," as Mukherjee called them: the woman who's a cancer survivor, the man whose prostate cancer is in remission, the woman whose sister has just been diagnosed with pancreatic cancer, the woman whose husband died of neuroendocrine cancer.
They sometimes come with pictures; they always come with stories.
And stories like these are at the core of Mukherjee's book. It's called a biography of cancer — and, indeed, it is, spanning attempts to thwart the disease from ancient Greece to today — but it's so effective because it chronicles the lives of people affected by the disease: patients, doctors, researchers. It's a stunning book, in part because Mukherjee brings some semblance of order to something truly chaotic. Nothing about cancer is controllable. Not even its narrative. Its past has been rewritten so many times; hopes raised only to be dashed. In a single sentence, he sums up the seemingly endless pursuit of a cure (which, as he eloquently describes in the book, isn't even an accurate term):
"Much about this battle will remain the same: the relentlessness, the inventiveness, the resilience, the queasy pivoting between defeatism and hope, the hypnotic drive for universal solutions, the disappointment of defeat, the arrogance and the hubris."
It is this lack of control, this "queasy pivoting between defeatism and hope" that drives much of cancer literature. Susan Sontag famously evoked it in her 1977 essay "Illness as Metaphor" as something akin to exile:
"Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place."
More recently, Robin Romm's seething memoir "The Mercy Papers" recounted her rage and despair in dealing with the last three weeks of her mother's life. It's a brutal book, sparing no one: not her mother, who lived for years with breast cancer, nor her father — nor even herself. In the book, Romm screams at social workers, behaves at times like a petulant child and refuses to shield the reader from the terrible details of her mother's disease. But it is that honesty that gives the book its power, that reminds us that platitudes in situations as fraught as this are unforgivable.
It is testimony, as Mukherjee says; it is the act of bearing witness. Romm behaves like a feral animal at times, but love is a base emotion — and really, isn't that how a child faced with losing her mother feels? She ends her book with 12 blank pages — a necessary and fitting pause after all that has preceded it. It's space before an afterword in which Romm writes about the journals her mother left behind. This is where we learn of Romm's decision to memorialize her mother; it all grew out of this entry her mother wrote years before:
"There came a moment in this journey when I freely realized that the lives most of us lead are small. Important, but small. Our radius reaches family, clients, friends for whom we do selfless and amazing feats. But our sphere of influence is local. … So our illnesses/deaths are small, too. Not unimportant. Just local in nature."
Nothing about cancer is local. When Alice Trillin died, Calvin Trillin received condolence letters from many people who had never even met Alice but who had known her as a character in Calvin's work. In 2006, Calvin Trillin published a slim memoir, "About Alice." It's a love letter, a eulogy, a portrait of a woman who was always interested in people and in life.
Although she describes in her New England Journal of Medicine essay how she distrusted the pursuit of any single-minded attitude toward cancer — fearing too cheerful or determined an approach might backfire should her condition worsen — she possessed the sort of zest and appreciation for life that feels like a trite notion when discussing life-threatening disease.
In that same essay, Alice Trillin wrote:
It astonishes me that having faced the terror, we continue to live, even to live with a great deal of joy. It is commonplace for people who have cancer — particularly those who feel as well as I do — to talk about how much richer their lives are because they have confronted death. Yes, my life is very rich. I have even begun to understand that wonderful line in "King Lear," "Ripeness is all." I suppose that becoming ripe means finding out that none of the really important questions have answers. I wish that life had devised a less terrifying, less risky way of making me ripe. But I wasn't given any choice about this.
She wrote, too, in that essay about people who simply decide that they won't let cancer stop them, that they will defeat the disease through sheer willpower. While she retained her skepticism of the notion, 20 years after she wrote that essay, she proved to have a rather ferocious will of her own. Calvin Trillin writes in "About Alice" of her determination to attend her daughter's wedding: She marched down the aisle only six hours after departing the hospital. Four months later, she would die of long-term side effects related to her cancer treatment.
After the wedding, though, Alice Trillin sent an email to friends recounting the experience:
"I was there for the whole thing, got to say my toast (quite moving) and eat chocolate cake and watch Bud's 87-year-old uncle Jerry … dance his ass off with Alice Waters, who had brought me roses from her garden in Berkeley." She adds that she was back home eating comfort food and about to watch TV and closes her message:
"Life doesn't get much better than this."
Jennifer Day is editor of Printers Row Journal.