The Enduring Appeal of Cancer Lit

IN 1964, when John Wayne referred to his lung cancer diagnosis, he called the disease the Big C. More than 20 years later, when Gilda Radner faced a diagnosis of ovarian cancer, she wrote in her memoir that no one wanted to use the word cancer, even as she was scheduled for surgery to remove it.

Over the last several decades, however, attitudes toward and treatment of cancer have changed. Survival rates for several types of cancer have improved dramatically. As I wrote in my own book Tumor, “Millions of people are living with or beyond cancer, carrying the diagnosis, sometimes carrying the disease, with them the rest of their lives.” In fact, there were an estimated 15.5 million cancer survivors living in the United States in 2016, according to the National Cancer Institute. A patient’s rights to privacy, information, and decision-making have expanded, as well. So patients and their families are more involved in the course of an illness. In addition, social media has blurred the boundary between private and public lives, so health information and illness anecdotes are being shared more openly.

One result of all this change seems to be more books about personal experiences with cancer — and readers are seeking out these cancer stories. In addition to best-selling cancer memoirs by patients — When Breath Becomes Air by Paul Kalanithi in 2016, The Bright Hour by Nina Riggs last year, and the forthcoming The Unwinding of the Miracle by Julie Yip-Williams — readers are also immersing themselves in the heartrending stories of cancer from the perspectives of loved ones and caregivers. The most popular of these memoirs is likely Wild: From Lost to Found on the Pacific Crest Trail by Cheryl Strayed, who hiked hundreds of miles through her grief after her mother’s death from cancer. In Reading and Writing Cancer: How Words Heal, Susan Gubar notes, “[W]e reside in the midst of the development of the cancer canon.”

Already this year, readers have two memoirs by women whose mother is diagnosed with cancer: All the Wild Hungers by Karen Babine and Joy Enough by Sarah McColl. McColl opens her memoir with a simple declaration and question: “I loved my mother, and she died. Is that a story?” That’s a good question. I could rattle off the titles of a half-dozen cancer memoirs in which that’s the basic premise. Do we really need another version of this my-mother-has-cancer tale that I, too, have lived? Yes, because experiences with cancer and our losses are varied, as are our perspectives. The cancer canon has an expansive landscape to map.

Babine’s mother is diagnosed with a rare type of cancer diagnosed in only about 350 people a year in the United States, almost all of whom are children under the age of 10. I know of only one other memoir about rhabdomyosarcoma, The Girl with Nine Wigs by Sophie Van Der Stap, and the one person I know who had this cancer was four years old at diagnosis. Babine’s mother is 65, so her oncology team has to adapt treatment for a grandmother. Surgery comes nine days after diagnosis, and then Babine’s mother is deemed cancer-free. Though the tumor has been removed, Babine calls this terminology “a false sense of security.” Chemotherapy follows surgery, and the family begins living treatment to treatment and scan to scan. As many families know, there’s never a way to go back to the way things were before cancer. Even toward the end of All the Wild Hungers, Babine writes, “My mother has no detectable cancer, but we still worry about those cancer seeds, waiting in the stillness to replant themselves.”

McColl’s mother is diagnosed with a cancer recurrence: “This cancer was not excisable; it was embedded in her bones, had burrowed its way into the marrow, nested in her soft organs.” There’s no possibility of becoming cancer-free for Allison, and the decline that’s already underway changes the way the author sees her own life. “When my mother was sick,” McColl writes, “I began to realize the future would never arrive. […] We were always only ever here.” For many of us who’ve lived scan to scan with our mothers, McColl captures not only the distortion of time that cancer can produce but also the desire for the terminal future to be staved off indefinitely. Babine’s waiting in the stillness is also McColl’s here to which she must cling.

What I appreciate most about both these memoirs is the ways they explore one of the most devastating aspects of cancer: cachexia, or wasting. While not all cancer patients lose the desire or ability to eat and not all cancer patients lose weight and muscle mass, wasting is not unusual. If only I could get her to eat something, I thought numerous times when my mother was sick with pancreatic cancer. How happy I was when she suddenly had a taste for a fried egg, and then asked for another the next day. But there are no effective therapies to combat cancer-driven wasting; not even improved nutrition halts it. The National Cancer Institute calls it “metabolic mutiny.”

McColl notes that her mother, a former rower with dense back muscles, lost 22 pounds and aged 20 years in six months. “Now, her body was a stranger’s. Unable to stand upright, she curled over a walker.” The oncologist had advised McColl’s mother to try not to lose more weight. “Here’s what I heard: If she eats, she’ll live,” McColl writes. As for many families doing their best to care for the patient, “Not dying seemed like a matter of meals.”

McColl was the founding editor of Yahoo Food, and there’s a lot of food in this short book. Importantly, whatever McColl’s mother has a taste for becomes a morsel of hope for survival. Peanut butter was off the grocery list; fish, steak, and fried chicken remained appealing. McColl snuck extra butter and oil — calories — into various meals. When her mother asked for second helpings, McColl went to bed “fist-pumping in triumph.” But later, the author notices that her mother, who always said that the skin of a baked potato contained the vitamins, had left hers uneaten.

Babine’s memoir is even more overtly about food, cooking, shared meals, and her desire to nourish her mother. Early on, we meet Agnes, the “orange Le Creuset cast-iron skillet, size 23” on a holiday “before I lost myself in the food metaphors of cancer.” Penelope Pumpkin is a two-quart Le Creuset, and Minnie is a three-quart Descoware. For Babine, cooking fills “the need to do something.” Stirring cake batter, simmering broth, and chopping food into bits turns frustration “into something wonderful and useful.” She is cooking against cancer.

When all her mother wants is comfort food, Babine says, “I will feed her whatever she feels she can eat.” Of roasted russet potatoes on Saint Patrick’s Day, Babine writes, “You could make a meal out of this, you think as you tuck in, thinking also about the rare strength your mother has to sit at the table tonight. She has not been to the table in days.” Babine cannot blame her mother for wanting carbohydrates instead of protein, fiber, and vitamins. Despite an array of pots, pans, and culinary expertise, Babine comes to unsettling terms with the wasting of her mother’s body: “[M]ind over matter was a terrible lie. […] She couldn’t force herself to eat.”

In addition to their honesty about wasting, another strength of these two books is their emotional range. While both authors explore the deep love they have for their mothers (and that their mothers have for them), they also deftly discuss frustration. Babine’s anger is the color of her first cast-iron skillet: “I am so angry in these days, my world a flare of bright orange. Anger is a secondary emotion, they say, a reaction to fear or vulnerability or frustration or injustice, an active reaction, rather than passive, and I walk the halls of the house, my belly simmering with something less than rage.” Babine exudes a passion that is inseparable from action, an inability to make sense of the conundrums of cancer, and, in this instance, a long sentence that can barely contain all her emotion. She’s angry because she can’t reconcile the urgency of a debilitating six months of chemotherapy with the delays in chemo treatment that all-too-common low blood counts necessitate. She’s angry because her mother’s oncologist has poor bedside manner and the nurses are patronizing, though her parents don’t see these interactions the same way. She wants to trust the experts — her sister is a nurse — and appreciate her mother’s acceptance of these contradictions, but Babine admits, “I don’t. I really don’t.”

McColl, too, writes of her frustration: “My rage was stealth. Its arrival never surprised me since I could feel it there, quiet but ever present in my body.” For McColl, it is often strangers who set her off. “Women riled me — generations of them who walked together arm in arm through the parking lot of the zoo, who posted photos from a bright hospital room where there were more eager arms than could hold a swaddled new baby.”

In fact, babies become inextricably linked to cancer in both these books. McColl wants to become pregnant because that is “the logical continuation of a circle, the reassurance to both of us that as she died, something of us grew.” She imagines that becoming a mother herself is the closest she can come to understanding her mother from the inside and also to knowing a mother’s love from the other side of the relationship. In All the Wild Hungers, Babine writes of her sister’s pregnancy, comparing the size of a 14-week fetus to a lemon and the size of a newborn to a cabbage, the same size as her mother’s tumor. She notes that both cancer and a fetus are the same thing at the most basic level: cells dividing. In Tumor, I write, “Cells do what they do, and cancerous versions of cells do what they do even better.” Whether cancer accumulating or an embryo forming, cells are geared to reproduce, to grow in or into a body.

Despite grappling with these shared topics of wasting, rage, and babies, All the Wild Hungers and Joy Enough are very different books. All the Wild Hungers is composed, in both senses of the word, calm, and put together with care. The word compose comes from the Latin meaning to place together. Just as Babine meets her mother in the place that is cancer, this book is a place readers meet both women when their being together is both heightened and threatened.

Joy Enough is a divorce memoir even as it is a cancer memoir. Echoing the book’s opening, McColl writes much later, “I loved my husband, and then I didn’t. Is that a story?” The couple argues about how to love and how to live. The demise of McColl’s marriage echoes Meghan O’Rourke’s memoir about her mother’s cancer, in which the man she dates felt as if O’Rourke chose her mother over him. Cancer can wreak havoc on even the strongest relationships. McColl steps out on her marriage in more ways than one and calls her life at that point “cliché-ridden trash.” After her divorce and then her mother’s death, McColl quits her job and enters graduate school, which she admits is also a “two-year grief program.” Her memoir tells a broader, longer story than Babine’s, and a lot of resolution happens in the last 10 pages.

With cancer, grief often begins at diagnosis or during treatment, and that underlies much of the cancer canon. The word grief, like the word gravity, comes from the Latin word for heavy. All the Wild Hungers and Joy Enough are ultimately about the heaviness that cancer introduces into our lives, that reorients us toward potential or inevitable separation. These books, however, are also very much about what holds us to each other.

¤

Anna Leahy is the author of the nonfiction book Tumor and the poetry collection Aperture. See more at www.amleahy.com.