412 RüdigerKunow
at least initially, plausible terms for the description of many of the
cancernarrativescirculatinginU.S.cultureandelsewhere.
Priortoaddressingquestionsofcontent,onemayspeakofcanceras
the name for a story of cellular life with a negative outcome. Leaving
aside for a moment the personal tragedies which form an inescapable,
affectivesubtextofallwehearandreadaboutcancer,onecan,fromthe
perspectiveofliterary andculturalcritique,identifyanumberofformal
characteristics and emplotments which are shared by many of them,
especially if they are written (as most of them are) from an
autobiographical perspective. One of these features is a temporal
urgency which both causes and characterizes many cancer stories. They
are narratives about a "suddenly irrupting, locally self-organizing,
systemically self-amplifying threat" (Massumi,Power20) to a person's
merephysicalexistence.Canceris,asIhavesaid,perceivedbymanyas
the silent killer, appearing unannouncedand with destructive intent—
evenatatimewhenmammographicscreeningsandotherearlydetection
methods are saving many lives, though at the price of an overload of
mistaken signs (read diagnoses), as patient initiatives claim. For others,
as in the Lacks case, by the time the first symptoms showed, it was
oftentimes(almost)toolateforacure (Skloot34;Sontag12).Addedto
the factor of temporal urgency, there is then the moment of deferral,
whichisadefiningcharacteristicinthesemioticsofcancer.
AlasdairMacIntyre'scommentthat"storiesarelivedbeforetheyare
told"(212),evenasitviolatesthesanctumsofconstructivism,offersan
interesting starting point for a theoretical inquiry into the narrative
dimension of the cancer experience. Medicine, also cancer medicine,
"beginswithstorytelling.Patientstellstoriestodescribeillness;doctors
tell stories to understand it," as Siddharta Mukherjee, himself an
oncologist and researcher, notes (390) and adherents of the "Narrative
Medicine" school would concur. In fact, pre-diagnostic symptom
recognition would be unthinkable without such narratives. They form a
semantic system poiting to a somatic condition. In medical contexts,
these narratives are a precondition for further preventive or therapeutic
action, while in cultural-critical contexts, they constitute a
methodological privileging of individual experiences over medical
classification.
This is also the point of intervention for a relatively new sub-
discipline at the borderline of the Humanities and Medicine, "Narrative