Writing Through Cancer

Each week I’m led off

to the clinic for my infusion

as if I’ll be handed a steaming,

fragrant cup of pleasure.

My wig’s a supercranial prosthesis

and I’m not a yacht but have my own port,

below my clavicle, so the poison

can go straight to my heart.

The chemo room is nothing

like the ocean

or even a river;

it’s a murky swimming hole

with snakes and gators and turtles…

(“Infusion Fridays,” by Terry Godbey.  Cancer Poetry Project, Vol. 2, 2013)

In 1978 Susan Sontag wrote Illness as Metaphor, now considered a classic, but at the time, described as Newsweek as “one of the most liberating books of its time.”  Sontag was a cancer patient during the time she wrote, and she not only explored how the metaphors—and myths—that surround cancer and other illnesses, can add to the suffering of patients.  But there was another side to Sontag’s narrative.  Writing in the January 26, 1978 issue of The New York Times, Sontag stated:

Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.  I want to describe not what it’s really like to emigrate to the kingdom of the ill and to live there, but the punitive or sentimental fantasies concocted about that situation; not real geography but stereotypes of national character. My subject is not physical illness itself but the uses of illness as a figure or metaphor.

Metaphors abound in our daily lives.  Some of you may recall how former White House counsel John Dean referred to “the cancer on the Presidency,” or in revised versions that followed, as a cancer within — close to the Presidency — that’s growing.”  Like it not, metaphors are powerful influences on how we think about illness or the state of the nation.  And in the “kingdom of the sick,” of cancer, metaphors exert a subtle or not so subtle influence on how we perceive and deal with our illness.

Not surprisingly, in our culture, physicians and patients alike often see cancer as a battle.  While “fight” or battle metaphors can provide meaning and purpose for many, in this country, war is the predominant metaphor used in the cancer experience.  According to Gary Reisfield and George Wilson, authors of the article “Use of Metaphor in the Discourse on Cancer,”

This metaphor [war] is ubiquitous in our society (witness, for example, the “wars on drugs, poverty, illiteracy and teen pregnancy).  It is easily adaptable to cancer…there is an enemy (the cancer), a commander (the physician), a combatant (the patient), allies (the healthcare team), and formidable weaponry (including chemical, biological, and nuclear weapons)… (in The Journal of Clinical Oncology, 2004).

They authors also point out that war is not the only metaphor used in the discourse on cancer.  Another commonly used metaphor points to also the universal “life is a journey,” overlaid on those whose lives have been altered by cancer.  They suggest that “the journey” metaphor may be more applicable to 21^st century cancer, as the disease has gradually transformed from an acute to a chronic illness, and for some, is enmeshed in an individual’s life narratives for years, even decades.

Yet I think it’s important to remember that the metaphors we use are deeply personal, whether in illness or used to describe other chapters of our lives.  The war metaphor may rankle some of us.  The journey metaphor might not capture what we experience ourselves.  Metaphors originate from what we know, what we have experienced in our lives.  As the poet Marge Piercy reminds us:

 Imagery comes directly out of your own core. It comes from how you perceive the world, how carefully you look and listen, how well you remember, how your mind works. What we have to draw on is largely dependent on how much attention we’ve paid to what’s within and outside of us.

This past Friday, I invited my Moores UCSD Cancer Center writers to explore the metaphors they use to describe their cancer experience.  We began by brainstorming, starting with the phrase, “Cancer is ___________________” and adding the images that came to mind.  The results were as varied and distinctive as the people in the room.  Cancer became a cockroach, a hidden bomb, a teacher, a menacing character loitering in a dark alley, an interruption, something unwanted, but hidden under layers of paint and wood rot, and for another, a flashlight in the forest of life.  From the generation of the metaphors each used to define their experience of cancer came longer narratives, the metaphor extended into a poem or story.

“This was challenging,” many said after we’d written and read aloud, and yet, “exciting.”  Our metaphors made the abstract visible, felt, something each person in the room could easily visualize.  Exploring the metaphors we use also helped us gain insight in and understanding of how we perceive and deal with cancer in our lives.

“Always in emergencies we invent narratives…Metaphor was one of my symptoms,” Anatole Broyard wrote in Intoxicated by My Illness, a memoir of his prostate cancer.  “I saw my illness as a visit to a disturbed country…I imagined it as a love affair with a demented woman who demanded things I had never done before…When the cancer threatened my sexuality, my mind became immediately erect.”

This week, pay attention to the metaphors you use every day to describe aspects of your life.  If you’re living with cancer, explore the metaphor that defines how you think about and navigate your way through it.  Begin with a little brainstorming as my group did this past week.  Then choose one, continue writing and see where it takes you.