In late May I put up a post explaining that I was ill with advanced prostate cancer. I wanted the fact of my illness known, so that readers of this blog would understand why my blogging might be interrupted now and again; but at the same time I was clear in my own mind that I wasn’t going to be making my illness a regular topic of discussion here. I haven’t done that and nor do I mean to start doing it. As important as the subject has become to me and those close to me, I don’t assume that my condition is a matter of wide interest.
There is, however, a general question about the way cancer is discussed that interests me. I came across it again last week, in a column by Mike Marqusee. While I will draw on my own experience in writing about it, it’s the interest of the general issue and not my personal experience that is my reason for doing so.
In some thoughtful reflections about how cancer is talked about, Mike – who was himself diagnosed with multiple myeloma several years ago – expresses his reservation about the habit of applying the language of warfare to the illness:
Some people feel buoyed when people compliment their “bravery”. Others, including me, find the bravery rhetoric around cancer deeply misconceived. It shifts responsibility on to the patient; if you succumb to your cancer, or even if you just complain about it, are you wanting in “bravery”? When someone tells me I’ve been “brave” I don’t know what to make of it. There’s no choice in the matter. This is a front line it’s impossible to flee from. [Italics mine – NG.]
It’s a reservation Mike has expressed before, saying that the language of a ‘war on cancer’ is misconceived. He doesn’t like the possible implication that someone who fails to beat their cancer might be failing on account of a personal ‘weakness or flaw‘.
It seems that Christopher Hitchens, who died of oesophageal cancer in December 2011, took a similar view. ‘I’m not fighting or battling cancer’, he wrote, ‘it’s fighting me.’ And, as Carly Weeks put the point of the objection in The Globe and Mail a while back…
A significant problem is that most of the common words and phrases we use to describe the experiences of people who have been diagnosed with cancer imply that personal will and self-control play a large part in determining who will live or die.
To say Mr. Layton lost his fight implies he had a say over his fate.
Now, although I don’t think the force of these reservations derives from the strict logic of the terminology of battle, I do agree with the concern that they embody. In strict logic there is no necessary implication that if you lose a battle it must reflect some moral weakness on your part. In warfare one side may lose to the other simply because the other is overwhelmingly stronger, whether in numbers, resources, military technology, or what have you. Still, in so far as talk of battle tends to get coupled with the use of morally suggestive terms such as ‘bravery’ and ‘courage’, it is easy for people to slip into thinking that the individual suffering from cancer has more of an influence over the outcome of the disease than he or she actually does. That is an extra and unnecessary burden for them to have to carry, over and above the burdens that just go with the illness itself.
Once this point is clearly registered, however, I would argue that there’s a perfectly meaningful sense in which contending with cancer is a battle of sorts, and that this sense should not be overlooked. From here on I argue mostly from my own experience, knowing as I do that different forms of cancer are different in their effects and also that different people have different experiences not only of the illness but also of the various treatments available to them. In any event, on the basis of what I’ve learned over the last five months, I would say that prostatic bone cancer can be felt as a constant battle. It’s a battle against tiredness. It’s a battle against sometimes desperately low levels of energy. It’s a battle against loss of appetite or the seemingly arbitrary whims of appetite, leading to rates of weight loss that, beyond a certain point, cannot be healthy for an already ill person. It’s a battle against nausea and against other physical discomforts that I won’t go into. People who have had a longer experience of chemotherapy than I so far have could add a number of other particular battles resulting from some of the side effects.
These various ‘battles’ – or hardships and attempts to cope with them – call for a daily effort in face of what can seem like a relentless assault on one’s wellbeing. What is the simplest of ordinary tasks for a healthy person can sometimes feel to the person with cancer as if it demands an extraordinary concentration of will: bathing, getting dressed, walking any distance, going out somewhere and encountering the normal ‘frictions’ of the world out there. Before I got ill I had no trouble walking a brisk three miles; since I’ve been ill the best I can manage without exhausting myself is 20 minutes ambling slowly. Even reading, something that might be thought not to require much physical energy, becomes rather more difficult if you’re more given to falling asleep through fatigue and being on painkillers. The same applies to concentrated thought, as in serious writing.
So while I would leave bravery out of this – since, as I see it, it’s not a matter of being brave, but merely of coping – and while I take back nothing of what I’ve said above in agreeing that a moralizing language of battle about cancer isn’t appropriate and, worse, potentially hurtful, I think there’s another way in which talking of a ‘battle against cancer’ fits well with what many people with cancer go through.