All Unhappy Families Are Alike

Russian-family-portraitIn commenting on my latest essay for “Good Letters,” a man “disabled from an odd condition” confided that, when his health crashed, he found himself abandoned by those he depended upon: “My family avoided me thinking that I repre­sented their destiny.” Years later “they still do,” he added.

Not everyone who lives with advancing death or a maladroit disability must live without his family’s succor and society. But I know exactly what this man is talking about, because my family too has avoided me since I was diagnosed with terminal cancer nearly seven years ago.

For five years my younger sister said nothing at all to me about the disease. My other sister will give a “like” to cancer updates on Facebook, but she never gets in touch with me. She doesn’t even leave a short encouraging comment. She clicks the “like” toggle and moves on. And, oh, oh, let me tell you about—but please stop me from tabulating grievances. Already I’m starting to remind myself of John McEnroe after a linesman’s bad call.

I also refuse to quote the first sentence of Anna Karenina, which is usually trotted out in these circumstances, principally because I think it is false. The truth is that unhappy families are more alike than happy families. Unhap­piness takes the universal forms of bitterness, resentment, and the symptom to which Kafka dedicated an entire novel—psychological arrest at an early stage, preventing emotional growth and development.

[Read more...]

How to Talk to the Dying

10142094Since being diagnosed nearly seven years ago with a lethal cancer, I have backed my old friends and new acquaintances into a quandary. What do you say to a dying man?

Strangers don’t seem to have any difficulty. Now that chemo­therapy has reduced me to a tattered coat upon a stick, I am routinely praised, when out in public with my four young children, “Oh, isn’t that sweet, you’re spending the day with your grandkids.” Under the guise of being nice, Americans can be breathtakingly rude. After about the hundredth time I was called their grand­father, I tried out a new reply: “These are my children. I am dying of cancer. The disease has prematurely aged me.”

Am I being cruel? Or merely repaying a pretense of frankness with the reality of frankness? The late Christopher Hitchens warned those who were blunt with their questions about his esophageal cancer to expect blunt­ness in return. [Read more...]

The Destruction of a Man

Boxer of QuirinalThis year 233,000 American men will be diagnosed with prostate cancer, while almost the same number of American women will be diagnosed with invasive breast cancer.

What breast cancer is for women prostate cancer is for men. And yet the funding of prostate cancer research is less than half that for breast cancer. In 2012, the National Cancer Institute spent $602.7 million on breast cancer, but only $256.3 million on prostate cancer. This amounts to $2,590 per new case of invasive breast cancer as opposed to $1,100 for every prostate case.

Feminists who complain about gender discrepancies in every other corner of American life are oddly silent about the discrepancy in cancer funding. But they do no more than mimic the silence of American men.

The National Football League, for example, promotes “A Crucial Catch,” a month-long campaign “to support the fight against breast cancer.” During October, NFL players wear pink game apparel, which is later auctioned off to raise money for breast cancer research.

And prostate cancer? The league does nothing whatever, even though—if the rates in the general population hold for them—242 of the men on the NFL’s active rosters this season will eventually come down with the cancer and forty-seven of them will die of it. [Read more...]

Quitting the Cancer Battle

Dessicated Seated NudeI am not a hero. After my last post, some readers wanted to know how I arrived at my attitude toward cancer, which is to be found somewhere between a religious person’s submis­sion and the cordial host’s welcome. A better question—one my oncologist and I wrestle with at every appointment—is why most cancer patients tumble into a bottom­less slough of despond.

My intention is not to criticize other cancer patients. To be told that you have a disease which is going to kill you in the next few months or years is to be slammed by a violent and remorseless truth that nothing in experience prepares you for. At first you can’t even process what your doctor is telling you, because there is nothing to which you can com­pare the news in order to make sense of it—it is a monster from beyond your imagination. Denial, self-pity, panic, despair: these are the natural reactions.

I was diagnosed with metastatic prostate cancer in the fall of 2007. Just before Sukkot my doctor phoned to warn that an “opacity” had shown up on my chest X-ray during a routine physical examination. To the Jews, Sukkot is zeman simhatenu, the “season of our rejoicing,” but there was little joy in our sukkah that year. Our season was one of dread. [Read more...]

The Mercy of Sickness before Death

Just so you understand: I am dying. I am in the end stage of metastatic prostate cancer, and after six-and-a-half years of close association with the disease, I have another six months to two years to live. That probably sounds exhibitionistic, but I don’t mean it to. Nor am I fish­ing for pity. Truth is, I’d sooner have your laughter.

Man says, “I’ve been diagnosed with terminal cancer, but I am going to fight it with everything I’ve got.” “My money’s on the cancer,” his friend says. Find me that friend.

When it is incurable, as mine is, cancer always wins in the end, but no one—I mean, no one—wants to hear any such thing. The preferred message in our culture is the sentimental one of hope. Hope is not, however, what the terminal cancer patient needs. Even if you believe in miracles, you cannot hope for one—not the way you hope the car’s skid comes to a stop before the cliff’s edge.

“By definition,” C. S. Lewis writes, “miracles must of course inter­rupt the usual course of Nature,” but if they were as common as mosquitoes in summer they wouldn’t be interruptions of the usual. [Read more...]


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