The New York Review of Books - USA (2020-11-05)

40 The New York Review

Cancer Under Capitalism

Nellie Hermann

The Undying: Pain,
Vulnerability, Mortality, Medicine,
Art, Time, Dreams, Data,
Exhaustion, Cancer, and Care
by Anne Boyer.
Picador, 308 pp., $26.00; $17.99 (paper)

There are, according to the sociologist
Arthur Frank, three kinds of illness
narratives: the restitution narrative, the
chaos narrative, and the quest narra-
tive. The restitution narrative, he wrote
in his influential book The Wounded
Storyteller (1995), is the one favored by
Western capitalism: it is the story told
in the TV commercial urging its recum-
bent viewer to buy cold medicine or the
hospital brochure printed in calming
colors; its plot is the ill person healed
by the marvels of modern medicine,
declaring, “Yesterday I was healthy,
today I’m sick, but tomorrow I’ll be
healthy again.” The chaos narrative,
told from within the period of illness,
“imagines life never getting better”
and struggles for coherence. But in the
quest narrative, illness is a journey:
along the way the sick person gains
something—usually insight, meaning,
or understanding—through the experi-
ence of suffering.
Anne Boyer’s The Undying is a book
about illness that doesn’t fit easily into
any of these categories. A reader en-
ters it expecting a memoir about Boy-
er’s journey through a diagnosis of and
treatment for breast cancer but quickly
learns that the book (despite the pub-
lisher’s classification on the back cover)
does not intend to meet such an expec-
tation. Instead, it is made up of varied
short sections, including philosophy,
examinations of statistics, thought ex-
periments, brief pieces that resemble
prose poems, ancient texts, recent sci-
entific studies, and even a few illustra-
tions. It incorporates and exhibits all
three of Frank’s narrative types, but it
ultimately resists them all.
Boyer, a self-proclaimed Marxist
feminist, tells her story only in the
service of a larger project—to explore
breast cancer as comprehensively as
possible: as a disease, as a historical
entity, as a means of exposing the pre-
carity of the individual inside larger
capitalist systems. “Cancer,” she writes,

is in our time and place one of the

most effective diseases at eradi-

cating the precise and individual

nature of anyone who has it, and

feminized cancers—in that to be

seen as a woman is also to be, in

a way, semi-eradicated, this eradi-

cation deepened by class, race, and

disability—even more so.

The Undying, which won the Pulit-
zer Prize last spring and has recently
been published in paperback, opens
with a discussion of influential women
who also had (and most of whom died
from) breast cancer: Alice James, Ra-
chel Carson, Jacqueline Susann, Susan
Sontag, Charlotte Perkins Gilman,
Audre Lorde, Kathy Acker, Eve Kosof-
sky Sedgwick, and Fanny Burney. Each
of them wrestled with how and why to
speak or write about her experiences
with the illness; if women’s stories are
often neglected, women’s illness sto-

ries are even more so. Carson, who was

diagnosed while writing Silent Spring

(1962)—a central work in the cultural

and environmental history of cancer—

never spoke publicly of the disease that

killed her four years later. Sontag’s

Illness as Metaphor (1978) directly

takes up the “conventions of conceal-

ment” surrounding cancer, exploring

how the mystifying language used to

describe the illness as a “fight” to be

won resulted in widespread shame and

secrecy, so that the name of the illness,

“felt to have a magic power,” came to

be rarely spoken out loud. Though

written after Sontag’s own cancer

treatment, it is distinctly not a personal

book. Lorde directly addressed the si-

lence surrounding cancer in the 1970s

with her book The Cancer Journals

(1980)—radically, Boyer notes, in light

of the decades before, using “the words

‘I’ and ‘cancer’ together.”*

Boyer is a poet and essayist. She has

previously written four chapbooks and

three books, most recently Garments

Against Women, a collection that

blurs the edges of poetry and prose as

it examines the political economy of

literature and what she calls “litera-

ture’s uses against women.” When she

was diagnosed at the age of forty-one

with triple-negative breast cancer, one

of the most aggressive forms, she was

raising a daughter alone, living on a

modest teaching salary in Kansas City.

Well-meaning friends and family sent

her illness memoirs, generally quest

narratives, in which a sufferer comes

through an affliction having found

some kind of meaning. These books

were not solace for Boyer so much as

spurs.

She is ambivalent about the word

“survivor,” with its false implication

that there is a reliable path that can

be followed to evade death. She states

in The Undying, “I do not want to tell

the story of cancer in the way that I

have been taught to tell it. I would

rather write nothing at all than pro-

pagandize for the world as is.” She

argues that to write only of oneself,

as if one lives in a vacuum outside of

larger cultural and historical struc-

tures, is to avoid grappling with the

larger systemic ways the disease has

been monetized in the United States,

and to ignore the way a person, hav-

ing become a patient, has entered a

broader capitalist story that engulfs

the individual one:

Breast cancer’s industrial etiology,

medicine’s misogynist and racist

histories and practices, capital-

ism’s incredible machine of profit,

and the unequal distribution by

class of the suffering and death

of breast cancer are omitted from

breast cancer’s now-common liter-

ary form.

After Boyer is diagnosed, she writes,

“The nurses give me a glossy binder

with a photo of a smiling silver- haired

woman on its cover. The title is Your

Oncology Journey, but I am certain

that trip can’t be mine.” She wants to

make clear that “to be diagnosed with

cancer right now is not to live in a bind-

er’s trajectory: your oncology journey

is a lie.” The images “beaming out from

cancer’s instructional materials” are

sanitized and scrubbed, bearing “no

mark of suffering, not from cancer, but

also not from anything else—not work,

not racism, not heartbreak, not pov-

erty, not abuse, not disappointment.”

Boyer observes that a cancer-

narrative writer risks becoming a cog in

the “machine of profit” as she narrates

her “journey” through the oncology

industry. With this she echoes Barbara

Ehrenreich’s 2001 essay “Welcome to

Cancerland,” which also takes up the

corporatization of breast cancer and

the “relentless brightsiding” that trans-

forms the illness into a “rite of passage”

for women, like gray hair or menopause.

Boyer refuses to succumb or contribute

to this phony cheer:

The system of medicine is, for the

sick, a visible scene of action, but

beyond it and behind it and be-

neath it are all the other systems,

family race work culture gender

money education, and beyond

those is a system that appears to

include all the other systems, the

system so total and overwhelming

that we often mistake it for the

world.

Her book, then, may be classified as

a memoir, but it is really a manifesto,

declaring that the telling of a single story

is in fact a lie, an act that elides the full

sinister horror of the system of cancer.

She uses the first person but also the

second and third; she uses a “you” and

more often a “we”—a collective voice

that creates a sororal sense, in conver-

sation, it seems, with Sontag’s statement

(which Boyer quotes in her prologue)

that “there is no ‘sororal’ death.”

Although Boyer resists the memoir

genre, and rages at it, she inevitably

writes inside of it. This wrestling against

her own—or any singular—experience,

which gives her book its power, occa-

sionally cripples her; she dodges and

weaves out of the way of her story so

much that she sometimes risks losing

her reader’s attention. She is aware of

this, however, and lets her resistance

show, so that the reader in turn finds

herself questioning how her own need

for a coherent story implicates her in

the systems she is reading about.

In ancient Greece, before the existence

of the modern hospital, sick pilgrims

sought out asclepeions, or healing tem-

ples, where they would sleep and wait

for prescriptions, delivered in dreams,

from the god Asclepius. Aelius Aris-

tides, a Greek orator who became sick

at the age of twenty-six, was one of

these pilgrims, suffering from a num-

ber of ailments that plagued him for

the second half of his life. He wrote

an account called Hieroi Logoi (Sa-

cred Tales) in the early 170s: a record

of his prescriptive dreams, his symp-

toms, and his personal relationship

Prune Nourry: Catharsis, 2019

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*Lorde’s The Cancer Journals has just

been reissued by Penguin Classics, with

a foreword by Tracy K. Smith.